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Early-onset scoliosis (EOS) is defined as a spinal deformity occurring before the age of ten years.
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Untreated EOS or early spinal fusion resulting in a short spine is associated with increased mortality and cardiopulmonary compromise.
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EOS may progress rapidly, and therefore prompt clinical diagnosis and referral to a paediatric orthopaedic or spine unit is necessary.
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Casting under general anaesthesia can be effective and may prevent or delay the need for surgery in curves of less than 60°.
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‘Growing’ rods (traditional or magnetically-controlled) represent the standard surgical treatment in progressive curves of 45° or greater.
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Children with congenital scoliosis associated with fused ribs benefit from surgery with a vertical titanium prosthetic rib.
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Surgery with growth-friendly instrumentation is associated with a high risk of complications.
Cite this article: EFORT Open Rev 2018;3 DOI: 10.1302/2058-5241.3.170051
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Search for other papers by Ilkka Helenius in
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Management of scoliosis in young children needs a comprehensive approach because of its complexity. There are many debatable points; however, only serial casting, growing rods (including traditional and magnetically controlled) and anterior vertebral body tethering will be discussed in this article.
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Serial casting is a time-gaining method for postponing surgical interventions in early onset scoliosis, despite the fact that it has some adverse effects which should be considered and discussed with the family beforehand.
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Use of growing rods is a growth-friendly surgical technique for the treatment of early onset spine deformity which allows chest growth and lung development. Magnetically controlled growing rods are effective in selected cases although they sometimes have a high number of unplanned revisions.
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Anterior vertebral body tethering seems to be a promising novel technique for the treatment of idiopathic scoliosis in immature cases. It provides substantial correction and continuous curve control while maintaining mobility between spinal segments. However, long-term results, adverse effects and their prevention should be clarified by future studies.
Cite this article: EFORT Open Rev 2020;5:753-762. DOI: 10.1302/2058-5241.5.190087
