Unilateral convex sliding growing rod as a novel technique in early-onset scoliosis

This study introduces and evaluates the unilateral convex sliding-growing rod (UCSGR) technique, a novel growth-guiding approach for early-onset scoliosis (EOS). The UCSGR aims to achieve deformity correction while preserving spinal growth and minimizing morbidity by using instrumentation solely on the convex side. A retrospective analysis was performed on EOS patients treated with UCSGR between 2018 and 2022 at a tertiary spine center. Eighteen patients were screened; 11 met inclusion criteria and completed greater than or equal to 24 months of follow-up. Clinical and radiographic outcomes-including Cobb angle, annual T1-S1 spinal growth, operative parameters, and complications-were analyzed. Curve flexibility and morphology were assessed on preoperative bending films. The cohort (mean age: 4.9 years, range: 3-7) included congenital (36.4%), spina-bifida-associated (27.3%), and juvenile idiopathic scoliosis (36.4%). Mean follow-up was 47.3 months. The average Cobb angle improved from 69.7° preoperatively to 26.4° postoperatively, yielding 63.5% correction ( P = 0.018). Annual spinal growth averaged 9.8 mm. Mean operative time was 203 min, and blood loss 225 ml. Two complications occurred-one rod fracture requiring revision and one superficial infection treated conservatively. No neurological deficits or spontaneous fusion were observed. The UCSGR technique provides substantial deformity correction with maintained spinal growth and a low complication rate. By leveraging convex-side biomechanics while preserving concave structures, it offers a promising alternative to bilateral growth-friendly constructs. Multicenter studies with longer follow-up are needed to confirm its long-term safety and efficacy.