Current Concepts in the Treatment of Early Onset Scoliosis

Abstract

Despite many surgical advances in the treatment of early onset scoliosis (EOS) over the past two decades, this condition remains a challenge to address. While otherwise healthy children can have EOS, many of these patients have complicated comorbidities making proper treatment algorithms extraordinarily difficult. Non-operative measures can be successful when initiated early, but are many times utilized as a delay tactic until growth-friendly operative procedures can be safely performed. This article will summarize the current concepts in the treatment of EOS with a focus on the surgical advances that have recently been made.

Keywords: casting; congenital scoliosis; early onset scoliosis; magnetically controlled growing rods; vertebral body tethering.

Figure 1

Preoperative sitting PA and lateral views of a 5-year-old female with cerebral palsy and associated neuromuscular scoliosis.

Figure 2

Postoperative radiographs of the same patient at 6 weeks and 3 years postimplantation of magnetically controlled growing rods with sustained curve control and excellent sitting balance.

Figure 3

Preop, immediate postop, and 6 years postop with gradual correction with the spring distraction system.

Figure 4

Preoperative images of a 3-year-old male with progression despite prolonged casting.

Figure 5

The same patient at six weeks after instrumentation utilizing Shilla technique.

Figure 6

Pre- and postoperative imaging of a female patient with early onset scoliosis treated with anterior vertebral body tethering.