TY - JOUR
T1 - Early-onset scoliosis
T2 - A review of history, current treatment, and future directions
AU - Yang, Scott
AU - Andras, Lindsay M.
AU - Redding, Gregory J.
AU - Skaggs, David L.
N1 - Funding Information:
Dr Andras owns stock in Eli Lily, receives publishing royalties from Orthobullets, and is a board or committee member of the Pediatric Orthopaedic Society of North America and the Scoliosis Research Society. Dr Skaggs has received grants from the Pediatric Orthopaedic Society of North America & Scoliosis Research Society, paid to Columbia University; has received consulting fees or honoraria from Biomet, Medtronic, Zipline Medical, Inc, and Orthobullets; is a board member of the Growing Spine Study Group, Scoliosis Research Society, and Growing Spine Foundation; has received payment for lectures including service on speakers'' bureaus from Biomet, Medtronic, and Johnson & Johnson; is a patent holder for Medtronic and Biomet; has received royalties from Wolters Kluwer Health-Lippincott Williams & Wilkins and Biomet Spine; and has received payment for the development of educational presentations from Stryker, Biomet, Medtronic, and Johnson & Johnson. Drs Yang and Redding have indicated they have no potential confl icts of interest to disclose.
Publisher Copyright:
© 2016 by the American Academy of Pediatrics.
PY - 2016/1
Y1 - 2016/1
N2 - Early-onset scoliosis (EOS) is defined as curvature of the spine in children >10° with onset before age 10 years. Young children with EOS are at risk for impaired pulmonary function because of the high risk of progressive spinal deformity and thoracic constraints during a critical time of lung development. The treatment of EOS is very challenging because the population is inhomogeneous, often medically complex, and often needs multiple surgeries. In the past, early spinal fusion was performed in children with severe progressive EOS, which corrected scoliosis but limited spine and thoracic growth and resulted in poor pulmonary outcomes. The current goal in treatment of EOS is to maximize growth of the spine and thorax by controlling the spinal deformity, with the aim of promoting normal lung development and pulmonary function. Bracing and casting may improve on the natural history of progression of spinal deformity and are often used to delay surgical intervention or in some cases obviate surgery. Recent advances in surgical implants and techniques have led to the development of growth-friendly implants, which have replaced early spine fusion as the surgical treatment of choice. Treatment with growthfriendly implants usually requires multiple surgeries and is associated with frequent complications. However, growth-friendly spine surgery has been shown to correct spinal deformity while allowing growth of the spine and subsequently lung growth.
AB - Early-onset scoliosis (EOS) is defined as curvature of the spine in children >10° with onset before age 10 years. Young children with EOS are at risk for impaired pulmonary function because of the high risk of progressive spinal deformity and thoracic constraints during a critical time of lung development. The treatment of EOS is very challenging because the population is inhomogeneous, often medically complex, and often needs multiple surgeries. In the past, early spinal fusion was performed in children with severe progressive EOS, which corrected scoliosis but limited spine and thoracic growth and resulted in poor pulmonary outcomes. The current goal in treatment of EOS is to maximize growth of the spine and thorax by controlling the spinal deformity, with the aim of promoting normal lung development and pulmonary function. Bracing and casting may improve on the natural history of progression of spinal deformity and are often used to delay surgical intervention or in some cases obviate surgery. Recent advances in surgical implants and techniques have led to the development of growth-friendly implants, which have replaced early spine fusion as the surgical treatment of choice. Treatment with growthfriendly implants usually requires multiple surgeries and is associated with frequent complications. However, growth-friendly spine surgery has been shown to correct spinal deformity while allowing growth of the spine and subsequently lung growth.
UR - http://www.scopus.com/inward/record.url?scp=84954131023&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84954131023&partnerID=8YFLogxK
U2 - 10.1542/peds.2015-0709
DO - 10.1542/peds.2015-0709
M3 - Review article
C2 - 26644484
AN - SCOPUS:84954131023
VL - 137
JO - Pediatrics
JF - Pediatrics
SN - 0031-4005
IS - 1
M1 - e20150709
ER -