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Objective <p>To investigate the long-term effects of continuous distraction using the One-Way Self-Expanding Rod (OWSER) on vertebral body remodelling and spinal growth in early-onset scoliosis (EOS).</p> Methods <p>This prospective, single-center phase 2 trial included 10 children with progressive EOS (median age 10.5 years) treated with bilateral OWSER constructs and followed for five years. Standardized anteroposterior radiographs were used to measure global spinal length (T1–S1, T1–T12) and vertebral morphology at the non-instrumented L4 level. Vertebral body height (VBH), width (VBW), and height-to-width ratio (VBH/VBW) were compared between baseline and five-year follow-up. Physiological vertebral growth expectations were derived from age-matched normative models (Peters et al., 2021). Paired t-tests assessed longitudinal changes (α = 0.05).</p> Results <p>Spinal length increased continuously from 30.3 ± 4.2&#xa0;cm preoperatively to 41.3 ± 3.2&#xa0;cm at five years (Δ = +10.98 ± 3.41&#xa0;cm, <i>p</i> &lt; 0.0001), corresponding to a mean annual postoperative growth of 1.06&#xa0;cm/year. The L4 vertebral body height rose from 22.4 ± 2.9&#xa0;mm to 28.8 ± 4.4&#xa0;mm (<i>p</i> &lt; 0.001), while width remained unchanged (<i>p</i> = 0.33), resulting in a + 22% increase in the VBH/VBW ratio. At five years, measured vertebral height exceeded age-predicted values by + 12% (<i>p</i> = 0.009), and the VBH/VBW ratio was 46% higher than physiological references (<i>p</i> &lt; 0.001). Apical vertebral body wedging also improved significantly: mean wedging decreased from 10.4° preoperatively to 3.4° at five years.</p> Conclusions <p>Continuous distraction with OWSER promoted not only sustained spinal growth but also intrinsic vertebral remodelling, demonstrating stimulation of vertical vertebral growth beyond normal physiologic trajectories. These findings support that OWSER induces a growth response rather than a purely mechanical elongation, offering a promising, minimally invasive approach for long-term growth preservation in EOS.</p>

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Continuous distraction with the one-way self-expanding rod promotes vertebral remodelling and stimulates spinal growth in early onset scoliosis: a prospective clinical trial

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  • 发表日期：

    2026年4月17日

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  • Amr Abdelhakam,
  • Nejib Khouri,
  • Lotfi Miladi

摘要

Objective

To investigate the long-term effects of continuous distraction using the One-Way Self-Expanding Rod (OWSER) on vertebral body remodelling and spinal growth in early-onset scoliosis (EOS).

Methods

This prospective, single-center phase 2 trial included 10 children with progressive EOS (median age 10.5 years) treated with bilateral OWSER constructs and followed for five years. Standardized anteroposterior radiographs were used to measure global spinal length (T1–S1, T1–T12) and vertebral morphology at the non-instrumented L4 level. Vertebral body height (VBH), width (VBW), and height-to-width ratio (VBH/VBW) were compared between baseline and five-year follow-up. Physiological vertebral growth expectations were derived from age-matched normative models (Peters et al., 2021). Paired t-tests assessed longitudinal changes (α = 0.05).

Results

Spinal length increased continuously from 30.3 ± 4.2 cm preoperatively to 41.3 ± 3.2 cm at five years (Δ = +10.98 ± 3.41 cm, p < 0.0001), corresponding to a mean annual postoperative growth of 1.06 cm/year. The L4 vertebral body height rose from 22.4 ± 2.9 mm to 28.8 ± 4.4 mm (p < 0.001), while width remained unchanged (p = 0.33), resulting in a + 22% increase in the VBH/VBW ratio. At five years, measured vertebral height exceeded age-predicted values by + 12% (p = 0.009), and the VBH/VBW ratio was 46% higher than physiological references (p < 0.001). Apical vertebral body wedging also improved significantly: mean wedging decreased from 10.4° preoperatively to 3.4° at five years.

Conclusions

Continuous distraction with OWSER promoted not only sustained spinal growth but also intrinsic vertebral remodelling, demonstrating stimulation of vertical vertebral growth beyond normal physiologic trajectories. These findings support that OWSER induces a growth response rather than a purely mechanical elongation, offering a promising, minimally invasive approach for long-term growth preservation in EOS.