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. Cite this article: EFORT Open Rev 2018;3 DOI: 10.1302/2058-5241.3.170051