A novel technique for treatment of progressive scoliosis in young children using a 3-hook and 2-screw construct (H3S2) on a single sub-muscular growing rod: surgical technique

Several different growing rod techniques have been described in the literature to treat progressive scoliosis in young children. Nevertheless, none of these techniques has shown a real superiority, and the rate of complications remains high. The purpose of this report is to describe an original fusionless method of treatment for this problem. The 3 hooks-2 screws (H3S2) construct consists of a single 5.5 mm titanium rod with three hooks proximally and two monoaxial pedicle screws distally, and some extra length of rod located distally and/or proximally that can be used for future lengthenings. To date, a total of 103 H3S2 constructs have been performed in our institution. This paper reports the preliminary results on 38 patients, with a minimum follow-up of 2 years. This procedure was found to be effective in maintaining scoliosis correction while allowing continued spinal growth and was associated with a low rate of complications. The H3S2 construct was found to have several advantages over the growing rod techniques as previously described in the literature. These include no need for post-operative bracing, fewer lengthening procedures and a lower rate of complications.