Our Summary

This research paper is about the different treatments for early-onset scoliosis (EOS), a condition where the spine of a child under 10 years old curves sideways. The goal of these treatments is to develop a healthy chest cavity, increase lung volume, and improve breathing function. There are two main types of treatments - conservative and surgical.

Conservative treatments are less intrusive and include things like wearing a brace, being placed in a cast, using halo-gravity traction (a technique that uses weights and pulleys to straighten the spine), and physiotherapy. The most effective non-surgical treatment is serial casting, where a series of casts are used to gradually straighten the spine.

Surgical treatments involve techniques that encourage the spine to grow in a more normal way. There are three main types, each using different amounts of force to correct the curve. The first, distraction-based systems, gently stretches the spine using rods. The second, compression-based systems, uses staples or tethers to squeeze the spine into a straighter shape. The third, growth-guided systems, guides the spine’s growth into a straighter shape.

There are also newer techniques like ApiFix, which corrects the spine while still allowing it to move. For severe cases, a combination of techniques may be used, or a section of the spine may be removed.

While these surgeries can preserve the child’s growth potential, they often come with high complication rates, long treatment times, and additional costs. The current treatments for EOS have their limitations, and which surgical technique is used can depend on the child’s specific condition, the surgeon’s experience, and the resources available in the country. The research into EOS and its treatments is ongoing and rapidly expanding.

FAQs

  1. What are the main types of treatments for early-onset scoliosis?
  2. What are the different types of surgical treatments for early-onset scoliosis?
  3. What are some potential complications and limitations of surgical treatments for early-onset scoliosis?

Doctor’s Tip

A helpful tip a doctor might tell a patient about scoliosis surgery is to follow the post-operative care instructions carefully. This may include restrictions on physical activity, wearing a brace or cast, attending physical therapy sessions, and taking prescribed medications. It is important to attend all follow-up appointments with the surgeon to monitor progress and address any concerns. Additionally, maintaining a healthy lifestyle with regular exercise and a balanced diet can help support the healing process.

Suitable For

Patients who are typically recommended scoliosis surgery are those with severe cases of scoliosis that cannot be effectively managed with conservative treatments such as bracing or casting. These patients may have a significant spinal curve that is causing pain, difficulty breathing, or other health complications. Surgery may also be recommended for patients who have not responded well to non-surgical treatments or whose condition is worsening despite conservative measures. Additionally, surgery may be recommended for younger patients with early-onset scoliosis to help prevent further progression of the curvature and to promote healthy spinal growth. Ultimately, the decision to undergo scoliosis surgery is made on a case-by-case basis by a team of healthcare professionals, including orthopedic surgeons, spinal specialists, and pediatricians.

Timeline

Before scoliosis surgery:

  1. Patient is diagnosed with scoliosis through physical examination and imaging tests.
  2. Patient undergoes non-surgical treatments such as wearing a brace, being placed in a cast, or using halo-gravity traction.
  3. If non-surgical treatments are not effective, the patient and their healthcare team may decide that surgery is the best option.

After scoliosis surgery:

  1. Patient undergoes pre-operative tests and evaluations to ensure they are healthy enough for surgery.
  2. Surgery is performed, which may involve distraction-based, compression-based, or growth-guided techniques.
  3. Patient is monitored closely in the hospital for a few days after surgery for any complications.
  4. Patient may need to wear a brace or cast post-surgery to support the spine as it heals.
  5. Patient undergoes physical therapy to regain strength and mobility in the spine.
  6. Follow-up appointments with the surgeon are scheduled to monitor the progress of the spine’s healing and to address any concerns or complications.
  7. Patient gradually resumes normal activities and may experience improved posture, reduced pain, and better lung function.

Overall, the timeline for scoliosis surgery can vary depending on the individual patient and the specific surgical technique used. It is important for patients to follow their healthcare team’s recommendations for post-operative care to ensure a successful recovery.

What to Ask Your Doctor

Some questions a patient should ask their doctor about scoliosis surgery include:

  1. What are the potential risks and complications associated with the surgery?
  2. What is the success rate of the surgery in terms of correcting the curve of the spine?
  3. What is the expected recovery time and rehabilitation process after the surgery?
  4. Are there any alternative treatments or less invasive options available?
  5. How experienced is the surgeon in performing this specific type of scoliosis surgery?
  6. Will the surgery impact the child’s growth potential or physical development?
  7. What are the long-term outcomes and potential follow-up treatments that may be needed?
  8. What is the cost of the surgery and will insurance cover it?
  9. Are there any lifestyle changes or restrictions that need to be followed post-surgery?
  10. What support resources are available for both the child and their family during the treatment process?

Reference

Authors: Zhang YB, Zhang JG. Journal: Chin Med J (Engl). 2020 Feb 5;133(3):351-357. doi: 10.1097/CM9.0000000000000614. PMID: 31904727