Abstract
The treatment of early-onset scoliosis is a rapidly developing field with the goals of promoting growth of the spine, maximizing thoracic volume to improve pulmonary function, and preventing further spinal deformity while the child grows to skeletal maturity. When the child reaches skeletal maturity and the end of growth-friendly treatment, spinal fusion may be indicated to stabilize the curve, correct residual deformity, and gain spinal length; however, spinal fusion at the end of growth-friendly treatment is associated with significant challenges such as spine stiffness and autofusion, previous incisions, retained implants, and psychologic consequences of multiple procedures. The purpose of this chapter is to highlight some of these issues in the decision-making process and treatment of patients at the end of growth-friendly treatment.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Sawyer JR, de Mendonça RG, Flynn TS, Samdani AF, El-Hawary R, Spurway AJ, Children’s Spine Study Group, et al. Complications and radiographic outcomes of posterior spinal fusion and observation in patients who have undergone distraction-based treatment for early onset scoliosis. Spine Deform. 2016;4:407–12.
Jain A, Sponseller PD, Flynn JM, Shah SA, Thompson GH, Emans JB, Growing Spine Study Group, et al. Avoidance of “final” surgical fusion after growing-rod treatment for early-onset scoliosis. J Bone Joint Surg Am. 2016;98:1073–8.
Poe-Kochert C, Shannon C, Pawelek JB, Thompson GH, Hardesty CK, Marks DS, et al. Final fusion after growing-rod treatment for early onset scoliosis. Is it really final? J Bone Joint Surg Am. 2016;98:1913–7.
Cahill PJ, Marvil S, Cuddihy L, Schutt C, Idema J, Clements DH, et al. Autofusion in the immature spine treated with growing rods. Spine (Phila Pa 1976). 2010;35:E1199–203.
Flynn JM, Tomlinson LA, Pawelek J, Thompson GH, McCarthy R, Akbarnia BA, Growing Spine Study Group. Growing-rod graduates: lessons learned from ninety-nine patients who completed lengthening. J Bone Joint Surg Am. 2013;95:1745–50.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG
About this chapter
Cite this chapter
Sheffer, B., Sawyer, J.R. (2018). The End Game for Early-Onset Scoliosis. In: El-Hawary, R., Eberson, C. (eds) Early Onset Scoliosis. Springer, Cham. https://doi.org/10.1007/978-3-319-71580-3_22
Download citation
DOI: https://doi.org/10.1007/978-3-319-71580-3_22
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-71579-7
Online ISBN: 978-3-319-71580-3
eBook Packages: MedicineMedicine (R0)