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Distraction Phenomenon After Lengthening of Spinal Growing RodsA Case Report
Denis S. Sakai, MD1; Lauren A. Tomlinson, BS1; John P. Dormans, MD1
1 Division of Orthopaedic Surgery, The Children’s Hospital of Philadelphia, 34th and Civic Center Boulevard, 2nd Floor, Wood Building, Philadelphia, PA 19104. E-mail address for D.S. Sakai: denis_sakai@yahoo.com. E-mail address for L.A. Tomlinson: tomlinsonl@email.chop.edu. E-mail address for J.P. Dormans: dormans@email.chop.edu
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Investigation performed at The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania



Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. One or more of the authors, or his or her institution, has had a financial relationship, in the thirty-six months prior to submission of this work, with an entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. No author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2012 by The Journal of Bone and Joint Surgery, Inc.
JBJS Case Connector, 2012 Sep 12;2(3):e45 1-4. doi: 10.2106/JBJS.CC.L.00002
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Extract

The treatment of early-onset scoliosis remains challenging, and growing-rod instrumentation has been shown to be an option for allowing trunk and lung development while partially straightening and controlling spine deformity1-4. Initial treatment with single rods had an unacceptable risk-benefit ratio3-6, and dual rods are currently preferred, achieving corrections from 30% to 64% at the time of the final spinal fusion3,7. Unfortunately, dual-rod systems retain complication rates ranging from 19% to 58%2,3,8,9 in instrumented patients. The most common complications include wound infections, skin breakdown, proximal and distal junctional kyphosis, and implant-related complications (e.g., rod breakage, implant prominence, and hook and/or screw pullout)8,10. Spontaneous fusion rates of 89% were also reported as a potential complication associated with submuscular rod placement and surgical procedures at early ages7,11, sometimes requiring osteotomies during the final posterior fusion7.
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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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