Shilla Growth Guidance Technique for Early Onset Scoliosis

Abstract

Surgical treatment for patients with early onset scoliosis (EOS) is frequently necessary, particularly for those patients who have significant deformity (>60°),have failed bracing or casting due to frailty or deformity progression, or have curves too stiff to modulate with non-operative methods. Surgical treatment of EOS can broadly be categorized as utilizing vertebral distraction, growth guidance, or tethering of the spine to accomplish and maintain the correction over time. The concept of growth guidance is based upon the knowledge that the child’s spine has a preprogrammed “normal” rate and pattern of growth, and, once the vertebral endplates are properly directed, vertebral growth occurs and therefore spinal height will be achieved. This chapter summarizes the indications, surgical technique, and outcomes of the Shilla growth guidance method. We present the case of a 3 year-old male child treated successfully for EOS with Shilla rods in place for 5 years without further surgery, achieving stable control of his deformity while allowing continued spinal growth.