OBJECTIVE The authors’ objective was to compare the intermediate outcomes of patients with severe congenital early-onset scoliosis (CEOS) treated with posterior vertebrectomy/hemivertebrectomy with short fusion and dual growing rods (hybrid technique [HT]) and those treated with traditional dual growing rods (TDGRs). METHODS A retrospective study of patients who underwent the HT and TDGR technique for CEOS was conducted. The inclusion criteria were CEOS (age < 10 years), Risser stage 0, treatment with HT or TDGR, index surgery performed between 2004 and 2017, and minimum follow-up of 3 years. For patients who completed lengthening procedures, the last lengthening procedure was considered the latest follow-up. Demographic, radiographic, clinical, and patient-reported outcomes and revisions were compared between groups. RESULTS Sixty-one patients with CEOS were included in this study, with 16 treated with HT and 45 with TDGR technique. There were no differences in age at index surgery, duration of treatment, or number of lengthening procedures. The lengthening interval was longer in the HT group. The preoperative mean ± SD main curve was 81.8° ± 17.1° for the HT group and 63.3° ± 16.9° for the TDGR group (p < 0.05). However, main curve correction was better in the HT group, and no differences in residual curve were found between groups. Although the preoperative apex vertebral translation (AVT) of the HT group was greater, the correction of AVT was better in the HT group (p < 0.05). No differences in T1–S1 and T1–12 height were found between groups at the latest follow-up. The growth of T1–S1 height was less in the HT group (p < 0.05), whereas the growth of T1–12 height was similar between groups. Patients in the HT group had a lower risk of mechanical complications but higher risks of dural tears and neurological complications. CONCLUSIONS HT may provide better correction and apex control ability than TDGR for EOS patients with severe and rigid deformity at the apex level, and it significantly decreased the risk of mechanical complications with little influence on growth of the thoracic spine. HT may be an option for patients with severe CEOS with large asymmetrical growth potential around the apex of the curve.

BACKGROUND: Combination of apical control convex pedicle screws (ACPS) with traditional dual growing rods (TDGRs) had better apex control ability for early-onset scoliosis (EOS); however, there is a paucity of studies on the ACPS technique. OBJECTIVE: To compare 3-dimensional deformity correction parameters and complications between the apical control technique (DGR + ACPS) and TDGR in the treatment of EOS. METHODS: A retrospective case-match analysis consisting of 12 cases of EOS treated with the DGR + ACPS technique (group A) from 2010 to 2020, and matched with TDGR case (group B) at a ratio of 1:1 by age, sex, curve type, major curve degree, and apical vertebral translation (AVT). Clinical assessment and radiological parameters were measured and compared. RESULTS: Demographic characteristics, preoperative main curve, and AVT were comparable between groups. The correction ability of the main curve, AVT, and apex vertebral rotation were better in group A at index surgery (P < .05). The increase in T1-S1 and T1-T12 height was large in group A at index surgery (P = .011, P = .074). The annual increase in spinal height was slower in group A, but without significant difference. The surgical time and estimated blood loss were comparable. Six complications occurred in group A, and 10 occurred in group B. CONCLUSION: In this preliminary study, ACPS seems to provide better correction of apex deformity, while attaining the comparable spinal height at 2-year follow-up. Larger cases and longer follow-up are needed to achieve reproducible and optimal results.