ArticleSpine deformity2026
Staged versus single-stage traditional growing rod implantation in severe early-onset scoliosis: complications and radiographic outcomes.
Article in Spine deformity, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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9 authors.
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Abstract
purposeTo compare staged, foundation-first (anchor-first) versus single-stage (same-day) traditional growing rod (TGR) implantation for early-onset scoliosis (EOS), with a prespecified focus on severe deformity and/or thoracic hyperkyphosis.
methodsIn this single-center cohort study, we performed a retrospective analysis of prospectively collected data from EOS patients treated with TGR. The primary outcome was the proportion of patients with at least one complication requiring unplanned surgery during growing-rod treatment (excluding post-final fusion surgeries). Radiographic outcomes were assessed at early postoperative (PO1mo) and final follow-up. A prespecified severe cohort was defined as preoperative max Cobb > 100° and/or thoracic kyphosis (T2-T12) ≥ 60°.
resultsFifty-four patients were included (same-day n = 39; staged n = 15), including 18 severe-eligible patients (same-day n = 6; staged n = 12). In the overall cohort, complications requiring unplanned surgery were similar between same-day and staged implantation (same-day 33.3% vs. staged 26.7%; RR 0.80; P = 0.751). In the severe cohort, staged implantation was associated with fewer complications requiring unplanned surgery (same-day 83.3% vs. staged 25.0%; RR 0.30; P = 0.043) and fewer total complication events per patient (P = 0.005). Radiographic correction and growth at PO1mo and final follow-up were comparable between strategies in the severe cohort.
conclusionStaged anchor-first TGR implantation was associated with fewer complications requiring unplanned surgery in the prespecified severe cohort, with comparable radiographic outcomes. These hypothesis-generating findings support further evaluation of staged implantation as a selective strategy for severe EOS in larger multicenter cohorts. LEVEL OF EVIDENCE: III.
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