Growing Rods for Infantile Scoliosis in Marfan Syndrome

Abstract

As life expectancy improves for patients with neonatal Marfan syndrome, spinal deformity becomes an important issue. Extensible spinal growing rods are an effective solution to the problem. Dual rods appear to be more corrective than single rods. Substantial spinal length can be obtained to minimize trunk disproportion. Growing rods may help prevent large infantile curves from becoming severe in Marfan syndrome, allowing definitive spinal fusion closer to skeletal maturity.

Frequent Small Distractions with a Magnetically Controlled Growing Rod for Early-Onset Scoliosis and Avoidance of the Law of Diminishing Returns

“…Prior to growing rod technology, spinal bracing or fusion had been advocated for treatment of EOS. [21][22][23][24] The TGR was developed to address the limitations of spinal bracing or fusion. 1,2,25 With the TGR, open surgical distraction is recommended every 6 months to correct the spinal deformity and facilitate spine growth.…”

“…1,2,25 With the TGR, open surgical distraction is recommended every 6 months to correct the spinal deformity and facilitate spine growth. [1][2][3][4]24,26,27 However, TGR is associated with limitations of repeat surgery under general anaesthesia 6,7 and the law of diminishing returns 5 caused by autofusion of the spine due to prolonged immobilisation by a rigid device or trauma to spinal ligaments. The optimal interval for the distraction procedure remains debatable.…”

Connective Tissue Syndromes: Themes and Guidelines for the Spine Deformity Surgeon

“…Although bracing has shown minimal success, it may still serve as a valuable delay tactic, especially in curves less than 20 degrees. In a series of 10 children with Marfans who developed scoliosis before age 3, with a mean curve of 80 degrees, the practice of ''growing'' rods showed promise if the curves exceed 65 to70 degrees [19]. Gains of trunk length of 10 cm or more were achieved in many of these patients.…”

Joint Hypermobility and Headache: Understanding the Glue That Binds the Two Together – Part 1

“…Severe pectus excavatum can necessitate surgical correction when heart compression is present . Early onset or increasing scoliosis may require intervention . Pregnancy increases the risk of aortic root dilation and high‐risk monitoring is required …”