Treatment strategies for early-onset scoliosis

Early-onset scoliosis (EOS) is defined as a spinal deformity occurring before the age of ten years.

Untreated EOS or early spinal fusion resulting in a short spine is associated with increased mortality and cardiopulmonary compromise.

EOS may progress rapidly, and therefore prompt clinical diagnosis and referral to a paediatric orthopaedic or spine unit is necessary.

Casting under general anaesthesia can be effective and may prevent or delay the need for surgery in curves of less than 60°.

‘Growing’ rods (traditional or magnetically-controlled) represent the standard surgical treatment in progressive curves of 45° or greater.

Children with congenital scoliosis associated with fused ribs benefit from surgery with a vertical titanium prosthetic rib.

Surgery with growth-friendly instrumentation is associated with a high risk of complications.