Early Onset Scoliosis: Future Directions

Abstract

The management of children with severe, progressive early onset scoliosis has been greatly advanced in the last decade, yet there is considerably more research to be accomplished in the future. In this concluding article, we review some of the major issues for future research with regard to this rare but potentially fatal disease. Despite the similar clinical appearances of the various forms of early onset scoliosis, the etiologies are different; however, little is known regarding etiology, particularly with regard to genetic defects. Further research is necessary to distinguish the various types of early onset scoliosis. Only by understanding the etiology can true advances be made in altering the natural history of early onset scoliosis. Research in the area of etiology will require increased funding through the National Institutes of Health and other agencies. Due to its low prevalence, early onset scoliosis currently does not have a high priority with these agencies. ### Growing Rods #### Single and Dual Growing Rods As discussed throughout this symposium, posterior instrumentation without fusion, with the use of single or dual growing rods, has been used to treat progressive early onset scoliosis in young children. The goals of treatment have been to achieve correction of the spinal deformity, maintain correction during the subsequent growth period, allow spinal growth and lung development, and avoid or eliminate the need for definitive fusion of the spine at an early age. A recent study has demonstrated improved surgical results with use of the dual growing rod technique1. These improvements are primarily due to the ability to achieve a more stable construct and to the performance of more frequent lengthening procedures. The results of a recent long-term study that examined the outcomes of the dual growing rod technique have confirmed that there is significantly better correction of scoliosis (p = 0.0256) and better achievement of growth1 …