Management of Early-Onset Scoliosis Treatments

Early-Onset Scoliosis (EOS) encompasses spinal curvatures arising before ten years of age, presenting unique challenges for thoracic development and respiratory function. Non-operative measures such as serial casting and bracing aim to control curve progression in early childhood, maximising chest wall growth while delaying or avoiding surgery. When conservative management proves insufficient, growth-friendly surgical strategies are employed. Traditional growing rods require periodic lengthening procedures, maintaining spinal alignment and promoting axial growth, although repeated interventions carry a risk of implant-related complications and psychosocial burden. Magnetically controlled growing rods offer distraction without repeated surgery but have shown mechanical failures tied to corrosion and actuator wear. Novel systems, including spring-based distraction devices, seek to provide continuous corrective force with fewer interventions. Definitive reconstructive techniques, such as posterior hemivertebra resection and fusion, are reserved for congenital anomalies unamenable to guided growth, delivering robust correction but at the expense of reduced spinal mobility. Optimal management balances curve correction, thoracic volume preservation, psychosocial impact and minimisation of complications.

Research from Nature Portfolio

Recent studies have demonstrated efficacy of bracing in progressive early-onset scoliosis, achieving up to 49% correction of the main Cobb angle in idiopathic cases and delaying surgical intervention by an average of nearly six years. Comparative analysis between congenital and idiopathic aetiologies revealed superior deformity correction and sustained chest height gains in idiopathic scoliosis, establishing bracing as a viable non-surgical alternative to casting for selected patients without compromising thoracic growth.

Management of Early-Onset Scoliosis Treatments publication trend

The graph below shows the total number of articles in management of early-onset scoliosis treatments across all publications each year (not limited to Nature Index journals).

Technical terms

Early-Onset Scoliosis (EOS): A spinal curvature of at least 10° manifesting before ten years of age.

Cobb angle: The standard measure of coronal spinal deformity, defined by intersecting lines at the endplates of the most tilted vertebrae.

Serial casting: A non-surgical method applying progressive plaster casts to correct or stabilise spinal curvature.

Growing rods: Expandable spinal implants designed to correct deformity while allowing continued axial growth through periodic lengthening.

Posterior hemivertebra resection: Surgical excision of a malformed vertebral segment via a posterior approach, followed by instrumentation and fusion to achieve definitive correction.

References

1. The efficacy of bracing in the treatment of progressive early-onset scoliosis. Scientific Reports (2024).
2. Surgical outcomes and complications of posterior hemivertebra resection in children younger than 5 years old. Journal of Orthopaedic Surgery and Research (2016).
3. Analysing a mechanism of failure in retrieved magnetically controlled spinal rods. European Spine Journal (2017).
4. Spring distraction system for dynamic growth guidance of early onset scoliosis: two-year prospective follow-up of 24 patients. The Spine Journal (2020).