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We have been fostering children in our home for the past 30 years. Many of our children come to us with medical problems. Our newest girl has scoliosis bad enough to consider surgery. When we had other children with this problem, it was years ago. We've been through surgery using those Harrington rods but I understand things have changed since then. What do they do now to correct severe curves?

Over the past 50 years, orthopedic surgeons have changed and improved the way spinal deformities are corrected in children. Safer and more effective ways to correct and hold the spine straight have been developed. It started with the use of the rods you mentioned. Placed alongside the spine to correct the curve, Harrington rods were used for a long time before newer, improved methods of fixation were developed. Wires were used for awhile. But there was a concern about the wires poking into the spinal cord and causing problems, so hooks were tried next. Hooks provided three-dimensional correction that was better and safer than wires. Most recently, screws placed through the pedicle (supporting column of the vertebral bones) have replaced rods, wires, and hooks. Pedicle screws are used in adults as well as children. But there is one safety concern with screws: putting them in the wrong place (misplacement). Computer-assisted navigation is helping to put an end to that problem. Over time, with continued improvements in technology, we should see even better accuracy rates of screw placement than the currently reported 95 per cent.

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