JBJS | Growth Modulation by Means of Anterior Tethering Resulting in Progressive Correction of Juvenile Idiopathic Scoliosis: A Case Report

The Journal of Bone & Joint Surgery, Volume 92, Issue 1

Case Reports | January 01, 2010

Growth Modulation by Means of Anterior Tethering Resulting in Progressive Correction of Juvenile Idiopathic Scoliosis: A Case Report

Charles H. Crawford, MD¹; Lawrence G. Lenke, MD²

¹ Spine Institute, 210 East Gray Street, Suite 900, Louisville, KY 40202
² Department of Orthopaedic Surgery, Washington University Medical Center, 660 South Euclid Avenue, Campus Box 8233, St. Louis, MO 63110. E-mail address: lenkel@wudosis.wustl.edu

The Journal of Bone & Joint Surgery. 2010; 92:202-209 doi:10.2106/JBJS.H.01728

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The treatment of juvenile idiopathic scoliosis continues to evolve with the search for ways to positively affect the natural history of deformity progression and disability while minimizing treatment morbidity¹. Traction, bracing, and casting are often the first treatment attempts to control the deformity, although many deformities will progress to surgical intervention^1,2. The goals of surgical treatment include correcting the deformity, or preventing progression of the deformity, while minimizing morbidity¹. Currently, deformity correction with instrumentation and fusion is the most commonly recommended and performed surgical intervention¹. Specific concerns associated with fusion include the cessation of spinal growth over the fused segments³ (which may negatively affect pulmonary function^4,5) and the potential for disc degeneration of segments adjacent to a long fusion. Because nonoperative treatment does not control progression in all cases^1,2, the search for alternative treatment of juvenile idiopathic scoliosis is warranted^1,6-12.

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adolescent idiopathic scoliosis ; regulation of growth ; spinal tethering

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These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.

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