Autofusion in growing rod surgery for early onset scoliosis; what do we know so far?

Open Access

Review

Table 1

Studies documenting the presence and implications of autofusion.

Study	Year	Authors	Design	Number of patients	Findings
Autofusion in the immature spine treated with growing rods [10].	2010	Cahill et al.	Retrospective, single centre	9	Rate of autofusion: 89% Average Cobb angle correction at the time of definitive fusion: 44% Average number of osteotomies per patient: 7
Avoidance of “final” surgical fusion after growing-rod treatment for early-onset scoliosis [15].	2016	Jain et al.	Retrospective, multicentre	167,137 underwent definitive fusion (final fusion group), 30 did not (observation group)	Average primary curve correction upon completion of treatment was 48% (from an initial average magnitude of 79° to a final average curve of 41°) No notable difference in the final curve magnitude between the two groups (41° in the observation group and 46° in the final surgical fusion group; p = 0.182)
Final fusion after growing-rod treatment for early onset scoliosis is it really final? [16].	2016	Poe-Kochert et al.	Retrospective, multicentre	100	30 complications necessitating reoperation (57 procedures) occurred in 20% of the patients On average, each patient experienced 1.5 complications following final fusion “Final” fusion may not actually be final
Graduation protocol after growing-rod treatment: removal of implants without new instrumentation is not a realistic approach [14].	2017	Kocyigit et al.	Prospective, single centre	26	90% of the patients in group 1 had progression of the deformity and this pathway was stopped due to ethical reasons
				Group 1 removed the rods without definitive fusion
				Group 2 removed the rods and underwent definitive fusion
Does the law of diminishing returns apply to the lengthening of the MCGR rod in early-onset scoliosis with reference to growth velocity? [17].	2017	Gardner et al.	Retrospective review of prospectively collected data, single-centre	28	No statistically significant difference in the amount of length achieved over the number of lengthening episodes

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