Abstract
Introduction
To present the technique and the outcomes of the use of the Shilla system in children scoliosis.
Materials and Method
The Shilla system has been used in 4 children of 5 ½ -8 years old to treat scoliosis of 60°-70°. To place the system, a subperiosteal approach of the apex and a percutaneous approach of the curve extremities had been performed. In that way, a spontaneous spinal fusion is avoided. The edging screws can slip on the rod and permit spine to grow-up. Cobb angle, screw slipping, T1-S1 lengthening, and complications had been recorded.
Results
The Cobb angle average improved to 22° from (65°) and the T1-L1 lengthening average was 6,8 cm. No spontaneous spinal fusion has been noted. In 2 children, a revision surgery to replace the upper thoracic screw and the rod had been performed. A left leg neurapraxia happened, which resolved after 1 week. A preserved sagittal balance of the spine was observed during the 3 years of follow-up.
Conclusion
The percutaneous placement of the thoracic screws is used to avoid spontaneous fusion, but this is challenging and increases the risk of complications. Despite the complications, in all the children, a good surgical correction of the scoliosis was done, a normal grow-up has been noted, and the sagittal balance was preserved instead of other expandable systems, which are fixed only at the curve extremities.