Turkish Neurosurgery
Use of growth rod systems for management of early onset scoliosis in cerebral palsy: A systematic review
Kshitij Gupta2, Sitanshu Barik1, Mosharaf Sarkar2, Sunny Chaudhary2, Sourabh Sinha2, Vikash Raj1, Pankaj Kandwal2
1All India Institute of Medical Sciences, Orthopaedics, Deoghar,
2All India Institute of Medical Sciences, Orthopaedics, Rishikesh,
DOI: 10.5137/1019-5149.JTN.41939-22.2

Aim Cerebral palsy is frequently associated with neuromuscular scoliosis with larger curves requiring surgical intervention. The aim of this study was to assess the literature for the role and outcome of growing rod surgeries in these patients. Methods A systematic search was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Electronic literature search was conducted of PubMed and Embase databases. Patient demographics, type of growing rod used, lengthening and complications were analyzed from the included studies. Results A total of 11 studies with poor overall study quality (Level of evidence IV, V) were included in the study. A total of 181 patients with mean age 6.8±1.3 (5-13 range) years at index surgery and mean follow-up of 3.02±1.3 (2-5.8 range) years were included in the study, with a female preponderance. The most common curve and instrumentation was thoraco-lumbar and conventional dual growing rods respectively. All studies showed improvement in Cobb’s angle and pelvic obliquity. There was better improvement in pelvic obliquity if pelvis was included in instrumentation. Wound related complications (34.6%) were most commonly noted. Conclusion Overall growing rod construct has shown questionable outcomes in cerebral palsy patients with scoliosis in terms of the complication rate observed although allowing growth of the spinal column with regular lengthenings. Magnetic controlled growth rods hold a bright promise for the future considering its ability to maintain correction as well as the lower rate of complications The benefits and risk of immediate fusion with respect to growth sparing surgeries should be considered before the decision.

Corresponding author : Sitanshu Barik