MCGR provides satisfactory deformity correction and avoids repeated surgical procedures for lengthening. However, it has substantial complication rate. Although less frequent than in GR, the law of diminishing returns also applies to MCGR.

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Six patients aged < or = 5 years with congenital scoliosis due to vertebral malformation were treated by anterior and posterior epiphysiodesis of the convexity. In all cases the pattern of deformity was a kyphoscoliosis. The average age at operation was 3 years 6 months, average follow-up was 4 years 6 months, and average preoperative angles were 42 degrees in the frontal and 36 degrees in the sagittal plane. The fusion included the malformative zone and the superior and inferior adjacent vertebrae. Two patients had a fusion effect, three patients had a true epiphysiodesis effect, and one patient had a postoperative progression of the deformity. Epiphysiodesis of the convexity is a treatment proper for the growing period, allowing the child either to reach skeletal maturity without needing further treatment or to achieve an adequate torso height to finish the treatment with a classical vertebral arthrodesis.

These techniques are effective in controlling early scoliotic deformity, and to some extent restore spinal growth. However, they show a high rate of complications: infection, rod breakage, spinal fixation pull out and, above all, progressive spinal stiffness, reducing long-term efficacy. Respiratory gain is harder to assess, as thoracic expansion does not systematically improve respiratory function, particularly due to impaired compliance of the thoracic cage.

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