| Purpose: To carry on an improvement design to the Plate-Rod Spinal System (PRSS), develop PRSS lengthener, resolve the problem of the titanium stick reserve length can't satisfy demand of the spinal column growth which appears in the PRSS clinical application. To evaluate the clinical curative effect in the treatment of the adolescent and child Idiopathic Scoliosis by PRSS and PRSS lengthener.Method: This research was divided into two parts. In the first part, 10 patients had PRSS for treatment of child idiopathic scoliosis and 2 among them accepted lengthening by PRSS lengthener 4 years later. In the second part ,8 AIS patients were treated by PRSS and 7 were treated by Universal Spine System (USS) . All patients had greater than 2-year follow-up. Radiographs were measured in coronal and sagittal planes for scoliosis Cobb angle and kyphosis angle of T5~T12. T1~S1 spinal column height was measured on the body of patients. Descriptive statistics were done to determine means and ranges. Changes in radiographic findings and body measure between preoperative, postoperative, and follow-up were tested using paired t test. Comparisons between groups on variables of interest were done using Student's t test. To summarize the clinical application of PRSS lengthener and evaluate its initial clinical curative effect.Result: The Cobb angle in child group be improved 56.7°(21~78°) averagly, the correction rate was an average of 69.85%. The scoliosis got an obvious improvement after the surgery. The Cobb angle hadn't obviously change two years larter. The Kyphosis angle of T5~T12 was correct 7°(- 8~17°) on averagely. The thoracic vertebra got a certain improvement on kyphosis after the surgery. In 2 years follow-up there hadn't crankshaftphenomenon. The average lengthening of T1~S1 was 4.77cm (4.1~5.8 cm). The height of spinal column was recovered after surgery. With follow-up two years, the T1~S1 spinal column height increased 3.44 cm(2.7~4.5 cm) averagely and the spinal column effectively regrowed.The ASI patients who used USS instrumentation was control group to the patients who ured PRSS. The spinal column length of T1~S1 was equally extended 4.58 cm, which similar to the 4.29 cm of USS group;The Cobb angle of PRSS group was improved with an average of 53.25°after the surgery, and the USS group was improved with an average of 52.29°, the result didn't show difference. In the meantime the T5~T12 kyphosis angle of PRSS group increase 8.63°equally, didn't show any difference with the average of 5°of USS group. PRSS has the similar ability with USS in the 3D orthopedic treatment of scoliosis. With follow-up after two years, the PRSS group T1~S1 spinal column height was equally increased 2.73 cm, the USS group is equally increased 0.27 cm. PRSS was good to reserve the spine grow function. Two years latter the kyphosis angle of T5~T12 of PRSS group equally lost 0.13°, but the USS group equally lost 3.86°. PRSS successfully avoided crankshaftphenomenon.Two patients received the operation of extend titanium stick by PRSS lengthener .Surgical operation time was 30~60 minutes and bleed about 200 ml. With follow-up 8 and 6 months there was no infection, PRSS lengthener loose movement and titanium stick loose. The scoliosis Cobb angle and the kyphosis angle of T5~T12 had no change, the spinal column continued to grow.Conclusion: PRSS system belongs to fusionless scoliosis surgery with reasonable design, simple structure, convenience operation and little complications. SPSS can effectively carry out the 3D orthopedics for child and adolescent idiopathic scoliosis with good biomechanics function. In the meantime SPSS can reserve the growth function of spine column and avoide the crankshaftphenomenon. SPSS is one of the most effective instrument for child and adolescent idiopathic scoliosis. PRSS lengthener can carry out titanium stick extension simply and effectively to solve the shortage of PRSS. It don't influence the function of 3D orthopedics and extention of PRSS.
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