Early-onset scoliosis: a narrative review

Geovanny Ruiz, Norberto J Torres-Lugo, Pablo Marrero-Ortiz, Humberto Guzmán, Gerardo Olivella, Norman Ramírez, Geovanny Ruiz, Norberto J Torres-Lugo, Pablo Marrero-Ortiz, Humberto Guzmán, Gerardo Olivella, Norman Ramírez

Abstract

Early-onset scoliosis (EOS) is defined as any spinal deformity that is present before 10 years old, regardless of etiology. Deformity must be evaluated based on the intercorrelation between the lungs, spine, and thorax. Curvatures of early-onset have increased risk of progression, cardiorespiratory problems, and increased morbidity and mortality. Progression of the deformity may produce thoracic insufficiency syndrome, where a distorted thorax is unable to support normal respiratory function or lung growth. Management and treatment of EOS should pursue a holistic approach in which the psychological impact and quality of life of the patient are also taken into consideration. Growth-friendly surgical techniques have not met the initial expectations of correcting scoliotic deformity, promoting thoracic growth, and improving pulmonary function.

Keywords: complications; early-onset scoliosis; growth-friendly surgery; outcomes; quality of life; thoracic insufficiency syndrome.

Figures

Figure 1
Figure 1
Graph shows the lung growth curve based on alveolar cell multiplication as a function of age. This summarizes several small autopsy series. The regression line was calculated by Dunnhill, (23) and the solid vertical line is the mean and range of the number of alveolar cells at maturity as reported by Angus and Thurlbeck . The synchronous thoracic volume increase is labeled as a percent of adult volume. Histographic sections of alveoli at the various stages of development are also shown. (Reproduced, with permission, from Campbell RM Jr, Smith MD. Thoracic insufficiency syndrome and exotic scoliosis. J Bone Joint Surg Am. 2007 Feb;89 Suppl 1:108-22; with permission from Wolters Kluwer Health, Inc.)
Figure 2
Figure 2
VACTERL syndrome patient’s radiographs Pre (A) and Post (B) Vertical Expandable Prosthetic Titanium Rib (VEPTR) Implantation.
Figure 3
Figure 3
Syndromic early-onset scoliosis (EOS) patient’s radiographs Pre (A) and Post (B) Magnetically Controlled Growing Rod (MCGR) Implantation.
Figure 4
Figure 4
Idiopathic early-onset scoliosis (EOS) patient’s radiographs Pre (A) and Post (B) Vertebral Body Tether (VBT) Implantation.

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