A novel technique for treatment of progressive scoliosis in young children using a 3-hook and 2-screw construct (H3S2) on a single sub-muscular growing rod: surgical technique

Introduction Several different growing rod techniques have been described in the literature to treat progressive scoliosis in young children. Nevertheless, none of these techniques has shown a real superiority, and the rate of complications remains high. The purpose of this report is to describe an original fusionless method of treatment for this problem. Materials and methods The 3 hooks–2 screws (H3S2) construct consists of a single 5.5 mm titanium rod with three hooks proximally and two monoaxial pedicle screws distally, and some extra length of rod located distally and/or proximally that can be used for future lengthenings. To date, a total of 103 H3S2 constructs have been performed in our institution. This paper reports the preliminary results on 38 patients, with a minimum follow-up of 2 years. Results This procedure was found to be effective in maintaining scoliosis correction while allowing continued spinal growth and was associated with a low rate of complications. Conclusions The H3S2 construct was found to have several advantages over the growing rod techniques as previously described in the literature. These include no need for post-operative bracing, fewer lengthening procedures and a lower rate of complications.