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Congenital Scoliosis: Epiphysiodesis



- Indications:
    - for patients with hemivertebrae only and no kyphosis;
    - age > 5 years (although some surgeons will perform this procedure on patients as young as 2.5 yrs);
    - short curvature of less than 50-70 degrees involving <  6 or less vertebrae;

- Technique:
    - epiphysiodesis and arthrodesis is performed both anteriorly and posteriorly on the convex side;
           - this will allow growth on the concave side;
    - convex 33% to 50% of vertebral end plates are removed and fused anteriorly, and only the convex half of the posterior spine is fused;
    - some curve correction is achieved with a postoperative cast;
    - postoperatively patients must wear a cast for 6 months;

- Results:
    - modest correction may be achieved averaging 10 degrees