Shilla Who is my Ideal Patient for Shilla

Shilla: Who is my Ideal Patient for Shilla? Scott J. Luhmann, MD Department of Orthopaedic Surgery Washington University School of Medicine

IIS: 3+8 years • Braced since 21 month of age • Marginal brace compliance 770

5+0 years 6 Spine casts 390 670 370 550 390 Standing 330 310 Supine

390 300 80

5+0: Shilla Procedure T 8 -T 9 PSF; PSSI T 3 -L 1 670 320

3 years postop

8+1; 3 years postop; B rod revision Imm. Postop 320 Imm. Postop 500

10+1 y/o; 5 years postop • T 1 -T 12: 210 mm • T 1 -S 1: 330 mm • CCW: 201 mm 510 Only 2 Surgeries! If traditional growing rods, then > 8 surgeries. Critique: Should have done 3 -4 level fusion

T 1 -T 12 LENGTH STRATIFIED BY AGE Female T 1 -T 12 Length Male T 1 -T 12 Length Female Height Male Height 200. 00 160. 77 T 1 -T 12 Length (cm) 29. 0 129. 00 149. 13 156. 82 144. 69 27. 0 129. 64 173. 53 162. 74 29. 70 28. 62 26. 87 140. 00 100. 00 80. 00 24. 22 60. 00 24. 26 23. 0 40. 00 21. 50 20. 00 21. 19 21. 0 Under 10 <10 yrs Mean age 160. 00 120. 00 26. 72 25. 0 180. 00 8. 7 yrs 0. 00 10 -12 years 12 -14 years 10 -11 yrs 12 -13 yrs 11. 1 yrs 12. 8 yrs 14+ years >14 yrs 15. 8 yrs h. EIGHT (CM) 31. 0

9. 5 y/o male, JIS SCM 23 o

9. 5 y/o male, JIS 5555

1 year s/p Shilla procedure PSF T 9 -T 11, PSSI T 3 -L 3 55 3 level apical fusion Blockers

1 year s/p Shilla procedure PSF T 9 -T 11, PSSI T 3 -L 3

“Ideal” Shilla Patient • 5 -10 years of age • Idiopathic dx – – “Normal” growth Good bone density Adequate pedicle size Good flexibility • Deformity – <70 o Coronal – Normal kyphosis Lifetime 0. 344 hitter > 0. 400 3 years

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