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Review
. 2016 Jul 20:9:241-6.
doi: 10.2147/MDER.S77657. eCollection 2016.

New developments in the treatment of early-onset spinal deformity: role of the Shilla growth guidance system

Sean M Morell  1 , Richard E McCarthy  2
Affiliations
Review

New developments in the treatment of early-onset spinal deformity: role of the Shilla growth guidance system

Sean M Morell et al. Med Devices (Auckl). .

Abstract

Early-onset scoliosis is a complex condition with multiple facets. The goal of treating any spinal deformity is to improve the condition of the patient with the least intervention necessary. A system that allows for continuation of natural spinal growth while correcting the deformity should be the goal of treating this complex condition. The SHILLA growth guidance system allows for continued growth of the pediatric spine while correcting and guiding the apex and guiding the future growth of the curvature. The system involves selective fusion across the apex of the curvature, and minimally invasive instrumentation is then used above and below the apex to allow for continued growth of the spine. A review of recent literature on the SHILLA growth guidance system shows promising results. Early animal models showed continued growth across unfused levels with minimal facet articular damage. Comparative studies to traditional growing rods showed significantly less total surgeries along with comparable correction and longitudinal growth. The SHILLA growth guidance system is a good option for this complex patient group. Results are comparable with other growing constructs with significantly less operative interventions. The SHILLA system allows for natural growth of the pediatric spine while correcting the scoliotic deformity in a minimally invasive method. The goal of this article is to present a comprehensive review of the SHILLA system surgical technique and the associated literature concerning this topic.

Keywords: SHILLA; early-onset; growing; growth friendly; scoliosis.

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Figures

Figure 1
Figure 1
The Shilla screw with cap and rod in final position.
Figure 2
Figure 2
The Shilla cap.
Figure 3
Figure 3
An example of the Shilla screw with cap. Note: This configuration allows for the rod to slide freely.
Figure 4
Figure 4
This image shows in situ wear on the rod from the Shilla screw.
Figure 5
Figure 5
In situ metallosis in patients. Note: In situ metallosis has been seen in many patients and has not shown any adverse effects on the individuals.
See this image and copyright information in PMC

References

    1. Thompson GH, Lenke LG, Akbarnia BA, McCarthy RE, Campbell RM., Jr Early onset scoliosis: future directions. J Bone Joint Surg Am. 2007;89(Suppl 1):163–166. - PubMed
    1. Williams BA, Matsumoto H, McCalla DJ, et al. Development and initial validation of the Classification of Early-Onset Scoliosis (C-EOS) J Bone Joint Surg Am. 2014;96(16):1359–1367. - PubMed
    1. Gupta MC, Gupta S, Vaccaro AR. Complex Spine Cases: A Collection of Current Techniques. New Delhi: Jaypee Brothers Medical (P); 2015.
    1. McCarthy RE, Luhmann SJ. Growth-Guided Instrumentation: Shilla Procedure. In: Akbaria BA, Yazici M, Thompson GH, editors. The Growing Spine, Management of Spinal Disorders in Young Children. 2nd ed. Springer; 2016. pp. 701–711.
    1. McCarthy RE. Shilla. In: Skaggs DL, Kocher MS, editors. Master Techniques in Orthopaedic Surgery, Pediatrics. 2nd ed. Wolters Kluwer; Wolters Kluwer; 2016. pp. 607–616.

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