• Jaime A Gomez, Melvin C Makhni, and Michael G Vitale.
• Orthopaedic Resident, Department of Orthopaedic Surgery, Columbia University Medical Center, New York, New York.
• Instr Course Lect. 2014 Jan 1;63:345-51.

AbstractThe management of complex spinal deformities in the growing child continues to evolve. The implementation of new techniques and biomaterial constructs has improved outcomes of deformity correction procedures but has also led to unforeseen complications. After spinal alignment through posterior instrumentation and fusion, progressive global decompensation in the coronal and sagittal planes or local decompensation in the vertebral segments adjacent to the fusion have developed in some children. These complications can lead to poor cosmesis, function, and quality of life, and a higher risk for revision surgery. Although postoperative spinal imbalance develops in few children, diligent monitoring of patients with predisposing risk factors for decompensation will allow surgeons to better predict, manage, and potentially prevent these complications.

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