Ideal Growing Rod System

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Presentation transcript:

Ideal Growing Rod System Richard E. McCarthy, M.D. Professor, Departments of Orthopaedics and Neurosurgery Arkansas Children’s Hospital University of Arkansas for Medical Sciences Little Rock, Arkansas

Premise: As we develop new systems we should agree upon what constitutes an ideal system Today no perfect system exists

System should be applicable to all forms of early onset deformity All ages Kyphosis and Scoliosis All types of diagnoses Should grow with the child Should grow at same natural rate as a child following growth charts Should avoid O.R. visits to lengthen

Minimize trips to O.R. Avoid infections Avoid implant loosening or breakage Avoid developmental and CNS effects of repeated anesthesias

Easy to apply Minimize time to implant Top loading Easy to explant at end of treatment

Maximize pulmonary function Lung space Maximize activity of child to increase PFT function Avoid PJK Product of distraction

Minimize prominence on child’s back Low profile for implants Minimize negative effect upon natural growth of spine Minimal number of growth segments arrested in order to lock in implant Avoid heterotopic bone

The device should be compatible and non-toxic to the child Need to minimize metal fretting and metallosis Should be MRI compatible Metal molecule size effects spread

The device should be strong enough to control the deformity and resistant to breakage

It should restore alignment in all planes 3 dimensionally Maintain the correction over entire period of growth

Should be easily removable or dissolve prior to adulthood

Ultimate goal is to send the child into adulthood with a spine: Well balanced Aligned close to neutral in all planes Free of metal Maximally mobile