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The Impact of Apical Vertebra Position on Outcomes of Growing Rod Treatment in Patients With Early Onset Scoliosis

June 15, 2022

A study published in the Journal of Pediatric Orthopaedics in March examined how outcomes of growing rod treatment for early-onset scoliosis can be influenced by the position of the apical vertebrae in relation to the growing rods.

The study was led by researchers from the Department of Orthopedics and Traumatology, at Hacettepe University Hospital; the Department of Aerospace Engineering, Middle East Technical University; the Department of Orthopedic Surgery, Cankaya Hospital in Ankara, Turkey; the Department of Orthopedics and Traumatology, Sandikli State Hospital in Afyonkarahisar, Turkey, and the Division of Pediatric Orthopaedic Surgery at UPMC Children’s Hospital of Pittsburgh.

Contributing to the study from UPMC Children’s was Ozgur Dede, MD, associate professor of orthopaedic surgery in the Division of Pediatric Orthopaedic Surgery.

In this retrospective study, the team reviewed data from a cohort of 58 patients meeting the study’s inclusion criteria who had growing rod treatment to correct early-onset scoliosis (children under the age of 10). Patients were grouped into three subgroups based on the position of the apical vertebra in relation to the position of the growing rods in order to determine the effect on lengthening and rotational control.

The team used postoperative patient radiographs combined finite element analysis modeling to confirm the clinical findings.

Broadly speaking, the team’s research found that in patients whose apex vertebra was brought close to the midline during index surgery achieved greater rotational control and distraction capacity which translates into more control of the spinal deformity, larger increases in height.

This is the first study of its kind to explore the relationship between apex vertebra position when using dual growing rod treatment for early onset scoliosis. 

Read more details of the study’s findings and investigative techniques using the link below.


Dursun G, Cetik RM, Guzel D, Demirkiran HG, Ramazanov R, Dede O, Gurses E, Yzici M. The Effect of Apical Vertebra Position on Growing Rod Treatment: A Clinical and Finite Element Study. J Pediatr Orthop. 2022 Mar 17. Online ahead of print.