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Growth Modulation by Means of Anterior Tethering Resulting in Progressive Correction of Juvenile Idiopathic ScoliosisA Case Report
Charles H. Crawford, III, MD1; Lawrence G. Lenke, MD2
1 Spine Institute, 210 East Gray Street, Suite 900, Louisville, KY 40202
2 Department of Orthopaedic Surgery, Washington University Medical Center, 660 South Euclid Avenue, Campus Box 8233, St. Louis, MO 63110. E-mail address: lenkel@wudosis.wustl.edu
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Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. One or more of the authors, or a member of his or her immediate family, received, in any one year, payments or other benefits in excess of $10,000 or a commitment or agreement to provide such benefits from a commercial entity (Medtronic).

Investigation performed at the Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri

Copyright ©2010 American Society for Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2010 Jan 01;92(1):202-209. doi: 10.2106/JBJS.H.01728
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Extract

The treatment of juvenile idiopathic scoliosis continues to evolve with the search for ways to positively affect the natural history of deformity progression and disability while minimizing treatment morbidity1. Traction, bracing, and casting are often the first treatment attempts to control the deformity, although many deformities will progress to surgical intervention1,2. The goals of surgical treatment include correcting the deformity, or preventing progression of the deformity, while minimizing morbidity1. Currently, deformity correction with instrumentation and fusion is the most commonly recommended and performed surgical intervention1. Specific concerns associated with fusion include the cessation of spinal growth over the fused segments3 (which may negatively affect pulmonary function4,5) and the potential for disc degeneration of segments adjacent to a long fusion. Because nonoperative treatment does not control progression in all cases1,2, the search for alternative treatment of juvenile idiopathic scoliosis is warranted1,6-12.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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