Growing Rods in Early-Onset Scoliosis

Abstract

Early-onset scoliosis (EOS) when progressive presents a significant challenge for the treating pediatric orthopedist. The basic dilemma of controlling a deformed spine over a prolonged time, while allowing growth of the child and maximizing long-term functional outcome is fraught with complications. Although traditional treatment methods, such as braces and casts, can be extremely helpful in this patient population, often factors such as curve magnitude, patient health, congenital malformations, and patient tolerance make these methods difficult to use in a long-term manner. The standard classification of scoliosis into age-based categories of infantile (3 years), juvenile (3-9 years), and adolescent (9 years) is somewhat useful in guiding treatment; however, it does not account for the natural growth of the spine. Data looking at the growth of the spine have shown children undergo their most rapid spinal growth between birth and 5 years old, thus making this period vital for the treatmentofscoliosiswhenpresent. 1 Additionally,theimmature lung increases the number of alveoli during the first 8 years of life, again demonstrating the importance of this time in maintaining a straight spine and adequate chest volume. 2 With this information and the understanding of the important link between early spinal growth, chest wall, and lung development, and ultimately lung function, the term “early