An alternate method of fixation for management of early-onset deformity with thoracic kyphosis.

Background: Although methods currently used for management of early-onset scoliosis are effective, the presence of excessive thoracic kyphosis is associated with an increased instrumentation failure rate.

Methods: An alternate method of upper thoracic fixation by using a 4-rib construct was developed by necessity when the author was presented with 2 cases of early-onset deformity with severe kyphosis and osteoporosis.

Results: With a minimum 3-year follow-up, both cases have demonstrated gratifying clinical and radiographic results.

Conclusions: This method is presented as an alternate method of upper thoracic fixation when increased pullout forces secondary to thoracic kyphosis are anticipated.

Level Of Evidence: IV.