Current State of Pedicle Screw Constructs in Children with Spinal Deformity

Pedicle screw use in children is a balance of safety and efficacy. Regardless of patient age or technique, pedicle screws provide 3-column fixation, load sharing surgical correction, long-term fixation, and continued growth for growing constructs. Pedicle screws are essential for 3-column fixation associated with vertebral column resection, hemivertebra excision, or fracture fixation. For nonfusion techniques, pedicle screws are excellent foundations at ends of implant constructs. The unique needs of young children for nonfusion techniques, such as traditional growing rods, Shilla, and staples, with associated regulatory challenges have led to off-label use of adult devices.