Our Summary

Early-onset scoliosis is a range of conditions where a child under 10 years old develops a spinal curve of 10 degrees or more. Regardless of the cause, it’s crucial to manage the curve to prevent it from worsening and causing heart and lung issues, reducing quality of life and lifespan. Diagnosing it can be tricky and is often by chance when they are young.

Choosing the right treatment depends on the child’s age, the cause, and how quickly the curve is progressing. Non-surgical treatments, like using a series of casts or braces, can be effective in stopping the curve from getting worse and delaying surgery. If surgery is needed, distraction-based systems and definitive arthrodesis (a type of spinal fusion surgery) have proven to be the most effective.

However, having surgery early can lead to a lot of complications. So, if possible, non-surgical options should be tried first, and surgery should be delayed until the child’s skeleton is fully grown.

Because of the serious risks linked to the curve and the treatment, it’s essential to educate the patient and their family about the importance of sticking to the treatment plan and regular check-ups.

FAQs

  1. What is early-onset scoliosis and how is it diagnosed?
  2. What factors influence the choice of treatment for a child with early-onset scoliosis?
  3. Why should surgery be delayed until the child’s skeleton is fully grown in cases of early-onset scoliosis?

Doctor’s Tip

Additionally, it’s important for the patient to follow post-operative care instructions carefully, including physical therapy and activity restrictions. It’s also crucial for the patient to maintain a healthy lifestyle, including regular exercise and a balanced diet, to support the healing process and overall spinal health. Lastly, regular follow-up appointments with the surgeon are essential to monitor the progress of the surgery and address any concerns or complications that may arise.

Suitable For

Ultimately, patients who are typically recommended for scoliosis surgery are those who have early-onset scoliosis with a spinal curve of 50 degrees or more, progressive curves that are not responding to non-surgical treatments, severe pain or discomfort, or significant cosmetic concerns. Additionally, patients with neuromuscular scoliosis, congenital scoliosis, or other forms of scoliosis that are causing complications such as breathing difficulties may also be candidates for surgery. It is important to consult with a spine specialist to determine the best course of action for each individual patient.

Timeline

Before surgery:

  1. Diagnosis of early-onset scoliosis, typically by chance during a routine check-up or due to symptoms such as back pain or uneven shoulders.
  2. Non-surgical treatments such as bracing or casting may be recommended to try to stop the progression of the curve.
  3. Regular monitoring of the curve through X-rays and clinical examinations to determine if surgery is necessary.
  4. Discussions with the patient and their family about the risks and benefits of surgery and the importance of following the treatment plan.

After surgery:

  1. Pre-operative preparations such as blood tests, imaging studies, and consultations with the surgical team.
  2. Admission to the hospital for the surgery, which can last several hours depending on the complexity of the case.
  3. Recovery in the hospital for a few days, followed by a period of rest and rehabilitation at home.
  4. Regular follow-up appointments with the surgical team to monitor the healing process and ensure that the curve is being properly managed.
  5. Physical therapy and rehabilitation to help the patient regain strength and mobility in the spine.
  6. Long-term monitoring of the spine to ensure that the curve does not progress and that the patient’s quality of life is maintained.

What to Ask Your Doctor

Here are some questions a patient or their family should ask their doctor about scoliosis surgery:

  1. What are the risks and benefits of scoliosis surgery for my child’s specific condition?
  2. How long will the recovery process be after surgery, and what can we expect in terms of pain and mobility?
  3. Are there any non-surgical options we should consider before moving forward with surgery?
  4. What are the long-term effects of scoliosis surgery, and how will it impact my child’s quality of life?
  5. How often will my child need follow-up appointments after surgery, and what will these appointments entail?
  6. Are there any lifestyle changes or restrictions my child will need to follow post-surgery?
  7. What type of scoliosis surgery do you recommend for my child, and why?
  8. What is the success rate of scoliosis surgery in cases similar to my child’s?
  9. Are there any alternative treatments or therapies we should consider alongside surgery?
  10. Are there any red flags or warning signs we should watch out for after surgery that may indicate complications?

Reference

Authors: Sauri-Barraza JC. Journal: Acta Ortop Mex. 2023 Mar-Apr;37(2):99-105. PMID: 37871933