SUMMARY
The benefits and drawbacks of growth friendly spinal instrumentation have been reported as a result of developments in the treatment of early-onset scoliosis. Seventeen patients who underwent growth friendly spinal instrumentation surgery with a minimum 2-year follow-up were included in the review. The mean number of lengthenings was 3, initial surgery age took place at 108.1 ± 30.2 months and follow-up at 40.6 ± 16.6 months. Spinal height (T1–S1 and T1–T12), space available for the lungs, major Cobb angle for scoliosis, maximum thoracic kyphosis, lumbar lordosis, shoulder and pelvic balance, and coronal and sagittal balance were assessed preoperatively and during the latest follow-up. Treatment with growth friendly spinal instrumentation provided an evident increase in spine height and space available for the lungs, and a significant decrease in scoliosis and thoracic kyphosis. In growth friendly spinal instrumentation treatment, the most commonly observed complications were proximal anchor problems (76.4%) and proximal junctional kyphosis (58.8%). In treatments using growing rods, excessive thoracic kyphosis correction should not be made to avoid proximal junctional kyphosis.