الفهرس 
Acknowledgements
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Abstract
Early-onset scoliosis is a difficult challenge. The affected patients are young with significant remaining growth potential. Thus, patients will likely develop progressive deformities, cosmetic disfigurement and cardiopulmonary consequences and probably a neurologic deterioration. Conventional management tools, such as spinal bracing and casting, have not been shown to be effective or tolerable. In addition, fusion may also cause significant inhibition of normal spinal and thoracic growth and so thoracic insufficiency syndrome.
Although higher incidence of complications have been linked with non fusion techniques they remain the mainstay treatment of EOS with the ability to obtain curve correction in association with maintence of lung and chest development and growth.
In this study, 21 patients with EOS were operated at Assiut University Hospital between 2009 and 2016 using 2 types of growing rods with a 6-month distraction protocol.
After collection of all radiologic data the following results were found.
Cobb’s angle
The major Cobb’s angle significantly improved from 82.33±4.67 to 55.19 ±4.89 (p<0.001) as illustrated in figure 28. This equals 32.9% improvement.
Kyphosis angle
The mean Kyphosis angle significantly improved from 60.71±4.53 to 49.38 ±3.20 (p<0.05) as illustrated in figure 29. This equals 18.6% improvement.
SAL ratio
SAL ratio improved from 67.02±2.95 to 90.57±1.78 (p<0.05) as illustrated in figure 30. This equals 8.44% improvement.
T1S1 Length
T1S1 length (mm) improved from 246.9±9.32 to 277.5±9.10 (p<0.05) as illustrated in figure 31.This equals 12.39% improvement.
Apical vertebral translation
AVT (mm) of the major curve significantly improved from 49.62±4.91 to 33.14±4.51 (p<0.05) as illustrated in figure 32. This equals (33.2%) improvement.
The overall success for lengthening and maintence of lung and chest development were reasonable.
Complications
A total number of 40 complications were noted in both groups ( in the 108 surgeries that were done) and were distributed as follow: 31 in the GSP group and 9 in the ISOLA group with a rate of 37% per surgery.
No single way of managing EOS was said to be totally free of complications. Also no single option is suitable for all patients. The surgical option and implant use should be tailored according to the patient status.According to the results of the current study we recommend using growing rods as a tool for management of EOS. Limitations in our study include Limited number of patients Lack of patient compliance reduced the number of patients The need for a longer follow up period ConclusionsWe recommend using growing rods as a useful tool for management of patients with EOS. We advise using dual rod technique instead of single rod, and also recommend using two adjacent ribs as a proximal anchoring point instead of a single rib.