STAGING GROWING ROD INSERTION DOES NOT LOWER COMPLICATION RATE COMPARED TO NON-STAGED PROCEDURES IN EARLY-ONSET SCOLIOSIS

Anchor-related complications are the leading cause for unplanned surgery (US) in early-onset scoliosis. One strategy to reduce US is staging implant insertion. This study compares the outcomes of staged (S) versus non-staged (NS) growing rod (GR) insertion, focusing on complication rates. This retrospective cohort study examined EOS patients who received GR surgery at a single institution between 2006–2023. Patients were grouped according to S and NS GR insertion. Radiographic measurements were obtained at pre-op, post-instrumentation and at one-year follow-up to determine radiographic change between and within each group. Complications were recorded until posterior spinal fusion (PSF) or until most recent follow-up if no PSF was performed, and compared between groups using the Kaplan Meier estimate. Patients were excluded if they had less than one year of follow up. Twenty-four patients received S, and 24 patients received NS dual GR insertion. S and NS patients had similar pre-operative Cobb angles (p=0.19), kyphosis angles (p=0.94), and thoracic height (p=0.79). Patients who underwent NS insertion had significantly greater Cobb angle correction (46.6±15.9%) compared to S patients (31.5±13.3%) (p Staged and non-staged GR instrumentation results in acceptable coronal correction and otherwise comparable radiographic parameters. However, based on an increased rate of complication, particularly in the first year post-operatively, and length of stay, staged insertion cannot be routinely justified.