Additional proximal fixation for growing rods in early-onset scoliosis (EOS) may offer a more effective and safer option for severe scoliosis patients with hyper-kyphosis. Here, we compared the outcomes of EOS patients treated with growing rods in which 6 proximal anchor points on 3 vertebrae were used vs. 4 proximal anchor points on 2 vertebrae. The records of patients with EOS treated surgically from January 2016 to December 2017 were retrospectively reviewed. In the Proximal 4 group, 2 vertebral bodies were anchored proximally with 4 anchor points; in the Proximal 6 group, 3 vertebral bodies were anchored proximally with 6 anchor points. Forty-two patients (mean age 5.11 ± 1.93 years) were included; 22 Proximal 4 group, 20 Proximal 6 group. Mean follow-up was 40.86 ± 13.49 months. The decrease in main curve Cobb angle postoperatively was significantly greater in the Proximal 6 group (33.22° vs. 19.08°) (P < 0.05). Cobb thoracic kyphosis (TK) was significantly decreased postoperatively in the Proximal 6 group (mean 20.70°); no significant decrease occurred in the Proximal 4 group. The main curve Cobb angle decrease at last follow-up was significantly greater in the Proximal 6 group (37.84° vs. 24.23°) (P < 0.05). Cobb TK was significantly decreased at last follow-up in the Proximal 6 group (mean 25.17°, P < 0.05); no significant decrease occurred in the Proximal 4 group. Instrument complications were lower in the Proximal 6 group (15.00% vs. 45.45%) (P < 0.05). No proximal junctional kyphosis was noted. Fixing 3 proximal vertebral bodies with 6 anchors improves radiographic outcomes of EOS treated with growing rods, and has a lower rate of screw pull-out.

早发性脊柱侧凸 (EOS) 中生长棒的额外近端固定可能为患有过度后凸的严重脊柱侧凸患者提供更有效和更安全的选择。在这里，我们比较了使用生长棒治疗的 EOS 患者的结果，其中在 3 个椎骨上使用6 个近端锚定点，与在 2 个椎骨上使用 4 个近端锚定点。回顾性分析2016年1月至2017年12月接受手术治疗的EOS患者的记录。在 Proximal 4 组中，2 个椎体通过 4 个锚点进行近端锚定；在 Proximal 6 组中，3 个椎体通过 6 个锚点进行近端锚定。纳入 42 名患者（平均年龄 5.11 ± 1.93 岁）；22 近端 4 组，20 近端 6 组。平均随访时间为 40.86 ± 13.49 个月。Proximal 6 组术后主曲线 Cobb 角下降幅度明显更大（33.22° vs. 19.08°）（P < 0.05）。Proximal 6 组术后 Cobb 胸椎后凸 (TK) 显着减少（平均 20.70°）；Proximal 4 组没有出现显着下降。Proximal 6 组末次随访时主曲线 Cobb 角下降幅度显着更大（37.84° vs. 24.23°）（P < 0.05）。Proximal 6 组末次随访时 Cobb TK 显着下降（平均 25.17°，P < 0.05）；Proximal 4 组没有出现显着下降。Proximal 6 组的器械并发症较低（15.00% vs. 45.45%）（P < 0.05）。未发现近端交界后凸。用 6 个锚钉固定 3 个近端椎体可改善使用生长棒治疗的 EOS 的放射学结果，并且螺钉拔出率较低。