Long-Term Outcomes of the Sliding-Growing Rod Technique in Early-Onset Scoliosis: Deformity Control, Spinal Growth, and Implant Survival

Study DesignRetrospective study.ObjectivesTo evaluate the long-term outcomes of sliding-growing rod technique (SGRT) in early-onset scoliosis and assess rod translation through the domino connector as a radiographic marker of preserved sliding function during postoperative spinal growth.MethodsConsecutive patients who underwent primary SGRT between 2012 and 2019 were reviewed. Inclusion required at least 5 years of follow-up and complete radiographic and revision data. Major Cobb angle, T1-S1 and T1-T12 lengths, and rod translation were measured serially. Correction-related length gain was analyzed separately from subsequent postoperative growth. Correlation analyses assessed the relationship between rod translation and T1-S1 growth, and revision-free implant survival was estimated using Kaplan-Meier analysis.ResultsTwenty-three patients were followed for a mean of 93.9 ± 16.8 months. The major Cobb angle improved from 78.9 ± 12.3° preoperatively to 19.3 ± 7.0° early postoperatively and was 24.6 ± 7.4° at final follow-up. Postoperative longitudinal length gain was 106.0 mm for T1-S1 and 72.9 mm for T1-T12, with annualized postoperative radiographic length-gain rates of 13.9 and 9.6 mm/year, respectively. Final rod translation was 56.4 ± 7.8 mm and correlated with postoperative T1-S1 growth (r = 0.73, P < .001). Four patients underwent unplanned revision. Revision-free implant survival was 95.7% at 2 years, 91.3% at 5 years, and 82.6% at 6 years. The mean final EOSQ-24 score was 79.9 ± 11.3.ConclusionsSGRT treatment was associated with durable correction, continued postoperative spinal length gain, and acceptable revision-free implant survival without planned lengthening procedures. Serial rod translation may provide a reproducible radiographic marker of preserved sliding function during follow-up.