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Purpose <p>To compare staged, foundation-first (anchor-first) versus single-stage (same-day) traditional growing rod (TGR) implantation for early-onset scoliosis (EOS), with a prespecified focus on severe deformity and/or thoracic hyperkyphosis.</p> Methods <p>In this single-center cohort study, we performed a retrospective analysis of prospectively collected data from EOS patients treated with TGR. The primary outcome was the proportion of patients with at least one complication requiring unplanned surgery during growing-rod treatment (excluding post-final fusion surgeries). Radiographic outcomes were assessed at early postoperative (PO1mo) and final follow-up. A prespecified severe cohort was defined as preoperative max Cobb &gt; 100° and/or thoracic kyphosis (T2-T12) ≥ 60°.</p> Results <p>Fifty-four patients were included (same-day <i>n</i> = 39; staged <i>n</i> = 15), including 18 severe-eligible patients (same-day <i>n</i> = 6; staged <i>n</i> = 12). In the overall cohort, complications requiring unplanned surgery were similar between same-day and staged implantation (same-day 33.3% vs. staged 26.7%; RR 0.80; <i>P</i> = 0.751). In the severe cohort, staged implantation was associated with fewer complications requiring unplanned surgery (same-day 83.3% vs. staged 25.0%; RR 0.30; <i>P</i> = 0.043) and fewer total complication events per patient (<i>P</i> = 0.005). Radiographic correction and growth at PO1mo and final follow-up were comparable between strategies in the severe cohort.</p> Conclusion <p>Staged anchor-first TGR implantation was associated with fewer complications requiring unplanned surgery in the prespecified severe cohort, with comparable radiographic outcomes. These hypothesis-generating findings support further evaluation of staged implantation as a selective strategy for severe EOS in larger multicenter cohorts.</p> Level of evidence <p>III.</p>

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Staged versus single-stage traditional growing rod implantation in severe early-onset scoliosis: complications and radiographic outcomes

  • 期刊论文

  • 发表日期：

    2026年7月7日

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  • Kota Watanabe,
  • Satoshi Suzuki,
  • Kazuki Takeda,
  • Takahito Iga,
  • Toshiki Okubo,
  • Masahiro Ozaki,
  • Narihito Nagoshi,
  • Morio Matsumoto,
  • Masaya Nakamura

摘要

Purpose

To compare staged, foundation-first (anchor-first) versus single-stage (same-day) traditional growing rod (TGR) implantation for early-onset scoliosis (EOS), with a prespecified focus on severe deformity and/or thoracic hyperkyphosis.

Methods

In this single-center cohort study, we performed a retrospective analysis of prospectively collected data from EOS patients treated with TGR. The primary outcome was the proportion of patients with at least one complication requiring unplanned surgery during growing-rod treatment (excluding post-final fusion surgeries). Radiographic outcomes were assessed at early postoperative (PO1mo) and final follow-up. A prespecified severe cohort was defined as preoperative max Cobb > 100° and/or thoracic kyphosis (T2-T12) ≥ 60°.

Results

Fifty-four patients were included (same-day n = 39; staged n = 15), including 18 severe-eligible patients (same-day n = 6; staged n = 12). In the overall cohort, complications requiring unplanned surgery were similar between same-day and staged implantation (same-day 33.3% vs. staged 26.7%; RR 0.80; P = 0.751). In the severe cohort, staged implantation was associated with fewer complications requiring unplanned surgery (same-day 83.3% vs. staged 25.0%; RR 0.30; P = 0.043) and fewer total complication events per patient (P = 0.005). Radiographic correction and growth at PO1mo and final follow-up were comparable between strategies in the severe cohort.

Conclusion

Staged anchor-first TGR implantation was associated with fewer complications requiring unplanned surgery in the prespecified severe cohort, with comparable radiographic outcomes. These hypothesis-generating findings support further evaluation of staged implantation as a selective strategy for severe EOS in larger multicenter cohorts.

Level of evidence

III.