Management of severe spinal deformities in young children with early-onset spinal deformity
(EOSD) is challenging (1). The goals of treatment are to stabilize the spine, prevent
further curve progression, and allow for spinal growth(2). Traditional non-operative treatment
options for early onset scoliosis include casting, orthotic treatment, or a combination
of the two were ineffective especially for long term use. Surgical treatment is indicated
when the non-operative management is not indicated , or fail to arrest the curve progression.
From all types of surgical treatment for EOSD, growth-oriented procedure may offer
the best hope for a final optimal spine and chest length, shape, and function(3). The principles
behind such treatment involve spinal instrumentation in distraction across an unfused
portion of deformed spine, followed by successive lengthening procedures to encourage
spinal growth(4). Several implant types exist, including dual growing rods with spinal anchors,
hybrid constructs using traditional spinal implants with hooks functioning as rib anchors,
and vertical expandable prosthetic titanium rib (VEPTR) devices(5). However, although
more secure fixation was achieved with the proximal hook and pedicular screws,
the “pullout” of the proximal fixation has been acknowledged as an inherent problem specially
in the presence of kyphosis. There has yet to be an effective means elucidated to
manage early onset thoracic kyphosis.
 

Conference Title

European Pediatric Orthopedic Society 2013

Conference Country

Palestine

Conference Date

Jan. 1, 1970 - Jan. 1, 1970

Conference Sponsor

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