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Growth Guidance System Straightens Spinal Deformities

By HospiMedica International staff writers
Posted on 10 Sep 2014
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Medtronic\'s SHILLA multi-axial screw
The SHILLA multi-axial screw (left) and fixed angle screw (right) (Photo courtesy of Medtronic)
A novel growth guidance system treats skeletally immature pediatric patients diagnosed with severe early-onset spinal deformities.

The SHILLA Growth Guidance System is intended for use in pediatric patients with a severe, progressive, life-threatening, scoliosis—defined as a greater than 40° coronal plane Cobb angle or a rib-vertebral angle difference greater than 20°—associated with thoracic and spinal insufficiency that requires surgical treatment before 10 years of age. The system maintains alignment correction and stability during growth, allowing the natural increase of trunk height and unimpeded development of the thoracic cavity. The system is intended to be removed after skeletal maturity.

A unique non-locking set screw at the proximal and distal portions of the construct's rods allow the rod to slide through the screw heads as the child's spine grows, while still providing correction of the deformity. The technology allows correction while maintaining alignment over time, minimizing the need for periodic lengthening procedures and offering effective management of spinal curvature while still harnessing the child's natural growth. The SHILLA Growth Guidance System is a product of Medtronic (Minneapolis, MN, USA), and has been approved by the US Food and Drug Administration (FDA).

“Early onset scoliosis is extremely difficult to treat. The current gold standard technique to manage scoliosis long-term is to fuse the spine, but in children who are still growing this can have serious complications,” said SHILLA inventor orthopedic surgeon Richard McCarthy, MD, of Arkansas Children's Hospital (Little Rock, USA). “Until now we were only able to offer operations which use implants to stabilize the curve in the spine, but these frequently mean twice-yearly surgeries as a child grows.”

Scoliosis is a medical condition in which the spine is curved from side to side. Although a complex three-dimensional deformity, on an X-ray the spine of an individual with scoliosis may look more like an "S" or a "C" than a straight line. Scoliosis is typically classified as congenital, idiopathic, or neuromuscular, when it has developed as a secondary symptom of another condition, such as spina bifida, cerebral palsy, spinal muscular atrophy, or physical trauma.

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Arkansas Children's Hospital


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