Strategies for Treating Scoliosis in Early Childhood

TY - JOUR

T1 - Strategies for Treating Scoliosis in Early Childhood

AU - Ridderbusch, Karsten

AU - Spiro, Alexander S

AU - Kunkel, Philip

AU - Grolle, Benjamin

AU - Stücker, Ralf

AU - Rupprecht, Martin

PY - 2018/6/1

Y1 - 2018/6/1

N2 - BACKGROUND: Scoliosis in early childhood is defined as abnormal curvature of the spine of any etiology that arises before age 10. The affected children are at high risk of developing restrictive pulmonary dysfunction. The treatment presents major challenges because of the complexity and high morbidity of the disease.METHODS: This article is based on pertinent articles retrieved by a selective literature search, and on the results of a retrospective study by the authors.RESULTS: In addition to conservative treatment methods including physiotherapy, casts, and corsets, progressive scoliosis usually requires early surgical intervention. In recent years, many different so-called non-fusion techniques have been developed for the surgical treatment of early childhood scoliosis. The goal of this new strategy is to avoid early fusion procedures and to enable further growth of the rib cage, lungs, and spine in addition to correcting the scoliosis. The authors also present their own intermediate-term results with a novel growth-preserving spinal operation that exploits magnet technology.CONCLUSION: Because of the low prevalence and heterogeneous etiology of early childhood scoliosis, the literature to date contains no randomized controlled therapeutic trials concerning this small group of high-risk patients. For the treatment to succeed, it is essential for specialists from all of the involved medical disciplines to work closely together. Conservative measures such as physiotherapy, casts, and corsets can delay the (frequent) need for surgery or even make surgery unneces - sary, particularly in the idiopathic types of early childhood scoliosis. The new non-fusion techniques enable continued growth of the spine, rib cage, and lung in addition to correcting the scoliosis.

AB - BACKGROUND: Scoliosis in early childhood is defined as abnormal curvature of the spine of any etiology that arises before age 10. The affected children are at high risk of developing restrictive pulmonary dysfunction. The treatment presents major challenges because of the complexity and high morbidity of the disease.METHODS: This article is based on pertinent articles retrieved by a selective literature search, and on the results of a retrospective study by the authors.RESULTS: In addition to conservative treatment methods including physiotherapy, casts, and corsets, progressive scoliosis usually requires early surgical intervention. In recent years, many different so-called non-fusion techniques have been developed for the surgical treatment of early childhood scoliosis. The goal of this new strategy is to avoid early fusion procedures and to enable further growth of the rib cage, lungs, and spine in addition to correcting the scoliosis. The authors also present their own intermediate-term results with a novel growth-preserving spinal operation that exploits magnet technology.CONCLUSION: Because of the low prevalence and heterogeneous etiology of early childhood scoliosis, the literature to date contains no randomized controlled therapeutic trials concerning this small group of high-risk patients. For the treatment to succeed, it is essential for specialists from all of the involved medical disciplines to work closely together. Conservative measures such as physiotherapy, casts, and corsets can delay the (frequent) need for surgery or even make surgery unneces - sary, particularly in the idiopathic types of early childhood scoliosis. The new non-fusion techniques enable continued growth of the spine, rib cage, and lung in addition to correcting the scoliosis.

KW - Adolescent

KW - Child

KW - Child, Preschool

KW - Conservative Treatment/methods

KW - Female

KW - Humans

KW - Male

KW - Retrospective Studies

KW - Scoliosis/diagnostic imaging

KW - Spinal Fusion/methods

KW - Treatment Outcome

U2 - 10.3238/arztebl.2018.0371

DO - 10.3238/arztebl.2018.0371

M3 - SCORING: Review article

C2 - 29932047

VL - 115

SP - 371

EP - 376

JO - DTSCH ARZTEBL INT

JF - DTSCH ARZTEBL INT

SN - 1866-0452

IS - 22

ER -