The treatment of early onset scoliosis has improved with recent advances in the last ten years. The purpose of this review was to provide the reader with a brief description of the new therapeutic modalities, their indications, and outcomes. In children with a progressive curve that is less than 60 degrees and in whom no surgical treatment has been performed, derotational bracing may be considered; however, the role of bracing is mostly limited to maintenance of correction after surgery. Dual growing rods appear to afford better correction initially, maintenance of correction, increased T1-S1 length, and decreased implant-related issues. However, complication rates remain problematic with younger children, children with neuromuscular disorders or syndromes, and children with a greater degree of curvature having the highest rates. Patient heterogeneity and short follow-up after surgery largely explain the subjectivity of surgical decisions that are not reproducible.

Management of early onset scoliosis

Principles of Intraoperative Management of Early-Onset Scoliosis

To evaluate the incidence and risk factors associated with the unplanned return to OR in EOS Medical records of 51 patients of EOS operated at three different centres using various types of GSCs were evaluated for complications requiring unplanned surgeries Data were analysed to find out rate of unplanned surgeries in relation to the aetiology, age and Cobb angle at index surgery, type of implant, cause of unplanned surgery, and management required Out of 51 patients, three did not meet inclusion criteria Forty-eight patients of EOS operated by GSCs with a mean age of 67 years (range 2–12 years) with an average follow-up of 673 months were studied There were 30 congenital, 10 idiopathic, 4 syndromic, and 4 neuromuscular cases Thirty-nine out of 48 patients had one or more unplanned surgeries on follow-up (8125%) Out of total 248 surgeries following index procedure, 82 were unplanned surgeries (3306%), including 53 implant revisions, 12 implant-removal, 14 debridement, and 2 flaps The common complications were 2414% rod/screw breakage, 4253% anchor pull-out, 1609% infections, 690% wound dehiscence, and 46% neuro deficits Unplanned surgeries were significantly higher in syndromic (588%) and neuromuscular (529%) than congenital (272%) and idiopathic (378%) cases (p   5 years (25 and 123 per patient, respectively,  p   005) GSCs in EOS require a frequent revisit to operation room which should be well understood by the surgeon and parents

Unplanned return to operation room (OR) following growing spinal constructs (GSCs) in early onset scoliosis (EOS)-a multi-centric study

Early Onset Scoliosis

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Early Onset Scoliosis