Our Summary

This research paper discusses the treatment of early-onset scoliosis, a condition in children where the spine curves abnormally. If not treated, this can be life-threatening. While surgery can be an option, it isn’t always the best solution and can often lead to complications. Recent studies have shown that non-surgical options can be effective in managing the condition, potentially even avoiding the need for surgery. Both surgical and non-surgical treatments aim to manage or correct the curve in the spine to allow normal lung development and delay more invasive treatment until the child is older. One specific non-surgical method, using repeated casting with a technique called the Cotrel and Morel elongation-derotation-flexion, can potentially completely correct the curve in the spine for some patients, particularly those with less severe curves.

FAQs

  1. What is early-onset scoliosis and how serious is it if left untreated?
  2. What are the goals of both nonsurgical and surgical treatment for early-onset scoliosis?
  3. Can nonsurgical treatment methods like the Cotrel and Morel elongation-derotation-flexion technique completely correct infantile idiopathic scoliosis?

Doctor’s Tip

One helpful tip a doctor might tell a patient about scoliosis surgery is to follow post-operative care instructions carefully to ensure proper healing and recovery. This may include restrictions on physical activity, wearing a brace or other supportive devices, attending physical therapy sessions, and attending follow-up appointments with the surgeon. It is important to communicate any concerns or changes in symptoms to the medical team to ensure the best possible outcome.

Suitable For

Patients with early-onset scoliosis, particularly those with severe or rapidly progressing curves, are typically recommended for scoliosis surgery. This includes patients who have not responded to nonsurgical treatments such as bracing, casting, or halo-gravity traction. Surgery may also be recommended for patients with progressive curves that are affecting their lung function or overall quality of life. Additionally, patients with certain underlying conditions such as neuromuscular scoliosis or congenital scoliosis may also be candidates for surgery to correct their spinal deformity. Ultimately, the decision to pursue surgery is based on the individual patient’s specific circumstances and the recommendations of their healthcare team.

Timeline

  • Patient is diagnosed with scoliosis through physical examination, X-rays, and other imaging tests
  • Patient undergoes a period of observation and possibly non-surgical treatments such as bracing, physical therapy, or chiropractic care
  • If the curve progresses and becomes severe, the patient may be recommended for surgery
  • Before surgery, the patient undergoes pre-operative evaluations and tests to ensure they are healthy enough for the procedure
  • The surgery is performed to correct the spinal curve using techniques such as spinal fusion, instrumentation, or vertebral body tethering
  • After surgery, the patient is closely monitored in the hospital for a few days to manage pain and monitor for complications
  • The patient undergoes physical therapy and rehabilitation to regain strength and mobility
  • Follow-up appointments are scheduled to monitor the patient’s progress and ensure the spine is healing properly
  • Over time, the patient may experience improved posture, reduced pain, and better quality of life as a result of the surgery.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with scoliosis surgery?

  2. What are the potential benefits of scoliosis surgery for my specific case?

  3. What is the expected recovery time and rehabilitation process following scoliosis surgery?

  4. Are there any alternative treatment options to surgery that I should consider?

  5. How will scoliosis surgery affect my daily activities and quality of life in the long term?

  6. What is the success rate of scoliosis surgery in terms of reducing spinal curvature and improving symptoms?

  7. Are there any specific pre-operative preparations or tests that I need to undergo before surgery?

  8. How experienced is the surgical team in performing scoliosis surgery, and what is their success rate?

  9. What is the long-term prognosis for my scoliosis if I choose to undergo surgery versus opting for non-surgical treatment options?

  10. Are there any specific post-operative care instructions or follow-up appointments that I need to be aware of after scoliosis surgery?

Reference

Authors: Thorsness RJ, Faust JR, Behrend CJ, Sanders JO. Journal: J Am Acad Orthop Surg. 2015 Sep;23(9):519-28. doi: 10.5435/JAAOS-D-14-00019. PMID: 26306805