I’m studying up on spinal surgery because my little adopted grandchild (8 years old) from Korea is about to have spinal surgery to fuse her spine. She came to us seemingly perfectly healthy but later developed scoliosis for no known reason. Now they are talking about putting screws through the bones to hold them in place. My concern is that the screws might cause further harm, damage, or even stunt her growth. What do they really know about this surgery?

It sounds like the surgeon has suggested using pedicle screws as a way to hold the spinal segments in place. Pedicle screws are placed through the supporting structure of the pedicle (a rigid column of bone on the backside of the vertebra).

Correcting a scoliosis (spinal curvature) and holding it in its new straighter location can be quite a challenge. In the past, long rods were placed on either side of the spine to hold it in place.

Over time, the rods have been replaced with wires, then hooks, and now screws. Each one of these fixation devices has its pros and cons. But the pedicle screws have a reportedly high success rate with good placement.

In fact, a recent study from the University of Minnesota reported an overall accuracy rate of 95 per cent in screw placement among children. That is even better than the 91 per cent accuracy rate for adults.

The question about using pedicle screws in children who have not completed their growth is a good one. Could this technique compromise the bone and slow (or even stop) bone growth? In theory, maybe — but in practice, no one has demonstrated or reported this yet. More studies are needed but for now, the use of pedicle screws in young children and teens is safe and effective.