The Use of Metal Sublaminar Wires in Modern Growth-Guidance Scoliosis Surgery: A Report of 4 Cases and Literature Review

R. Bogie*, J. J. Arts, S. N. Koole, L. W. Van Rhijn, P. C. Willems

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-review


Background: To avoid early fusion and allow residual growth of the spine in early onset scoliosis (EOS) treatment, growth-guided scoliosis surgery can be performed. Four patients with EOS are presented in which a growth-guidance instrumentation is used with sliding titanium (Ti) sublaminar cables. Residual growth of the spine can be preserved using metal sublaminar wiring; however, several drawbacks of this technique and type of material are illustrated.

Methods: Four patients with progressive neuromuscular scoliosis were treated with a posterior stabilization. A fusionless growth-guidance instrumentation was used consisting of a combination of lumbar pedicle screws and sliding Ti sublaminar cables along cobalt chrome rods.

Results: In 2 cases, the described growth-guidance technique provided sufficient stability and correction of the curvature with preservation of growth. In 2 patients, the instrumentation failed due to upper thoracic sublaminar wire breakage. The ongoing abrasion of the rod-wire interface caused severe metallosis. In these cases, a debridement and revision surgery was performed with partial fusion of the spine.

Conclusions: Growth-guidance techniques with sliding metal sublaminar wires seem to be a valuable solution for the preservation of spinal growth in EOS surgery. High curvatures, however, have a higher chance of failure and demand for more corrective strength and support of the instrumentation. The use of metal sublaminar wires in a ``sliding'' instrumentation can lead to early breakage and metallosis.

Original languageEnglish
Pages (from-to)182-188
Number of pages7
JournalInternational Journal of Spine Surgery
Issue number2
Publication statusPublished - 1 Apr 2020


  • scoliosis
  • growth guidance
  • sublaminar wires
  • titanium
  • metallosis

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