Normal Growth of the Spine

The growing spine is the product of more than 130 physes or growth plates. Growth is the basic determinant for treatment; it is a ratio between remaining and elapsed growth, and any surgical strategy should be adjusted according to remaining growth. As the spinal deformity progresses, not only spinal growth is affected but also the size and shape of the thorax are modified. There is a normal interaction between the organic components of the spine, the thoracic cage, and the lungs. Both early-onset spinal deformities and an early spinal arthrodesis alter spinal growth and affect thorax development by changing its shape and reducing its normal mobility. As a "domino effect," the distortion of the thorax will eventually interfere with lung development and cardiac function, leading those children to develop thoracic insufficiency syndrome and cor pulmonale, which can be lethal in the most severe cases. Understanding normal spinal growth is of utmost importance for all practitioners treating spinal deformities in the growing child