Hemiepiphysiodesis for the Treatment of Congenital Scoliosis

Abstract

In long, sweeping curves seen in congenital scoliosis, definitive fusion should be avoided as it may limit growth of the thoracic spine and lungs. In such cases, the treatment goal should be to correct the deformity and maintain spinal alignment while preserving growth. The convex growth arrest (CGA) procedure intends to modulate growth with inhibition on the convex side while allowing growth on the concave side of the deformity. The traditional technique with the combined anterior and posterior approaches does not allow immediate deformity correction and has been shown to have unpredictable results. The traditional CGA technique has been modified by performing the hemiepiphysiodesis on the convex side with pedicle screws and a rod in a posterior-only fashion and adding a growing rod construct to the concave side. In this chapter, we present a 3.5-year-old female patient with a long, sweeping congenital scoliotic curve that was managed with convex instrumented CGA and concave distraction technique.