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Older Children with Early Onset Scoliosis
Book chapter

Older Children with Early Onset Scoliosis

Stuart L. Weinstein, Lori A. Dolan and Joshua B. Holt
The Growing Spine, pp.729-736
Springer International Publishing
02/03/2022
DOI: 10.1007/978-3-030-84393-9_48

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Abstract

The long-term prognosis of untreated idiopathic early onset scoliosis (I-EOS) is a progressive deformity and potentially life-threatening pulmonary compromise. The treatment goals for early onset scoliosis (EOS) patients (of any etiology) are clear: minimize the deformity and maximize pulmonary function, while minimizing complications, procedures, and hospitalizations. What is not always clear, however, is how to achieve these goals, particularly for older patients. There is a lack of definitive evidence to guide treatment of patients who present between 7 and 10 years of age with EOS. Recent recommendations accompanying the new Classification for Early Onset Scoliosis (C-EOS) suggest that “…treatment principles for children between 5 and 10 years more closely resemble those used for children under the age of five years (growth friendly surgery) than they do for children over the age of 10 years (fusion surgery).” Most of the literature in this subset of patients is centered around thoracic spine height and its effect on pulmonary function and how treatment affects these parameters. In this chapter we will examine the current evidence base informing decisions in light of accepted treatment goals in this most challenging segment of the EOS population.
Complications Evidence-based medicine Idiopathic early onset scoliosis Nonoperative treatment options Operative treatment options Pulmonary function Shared decision-making Spine growth Thoracic height Thoracic length

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