Current Concepts in the Management of Early-onset Idiopathic Scoliosis

Ujjwal K Debnath


Pediatr Health. 2010;4(3):343-354. 

In This Article


A treatment outline for EOS may be as follows:

  • Curves less than Cobb angle of 25° with an RVAD less than 20° are preferentially observed and monitored with spinal radiographs at regular intervals (preferably 4–6 months interval);

  • Curves exceeding these parameters are typically braced, with some consideration given to the value of intermittent Risser casting;

  • Surgery is considered for curves not adequately controlled with non-operative measures;

  • Current options for surgical management of spinal deformity in the growing child include definitive spinal fusion with or without instrumentation, selective fusion, growth modulation, spinal instrumentation without fusion, or more recent expandable implant systems;

  • Growing rods are used for children below the age of 10 years and a curve magnitude exceeding 60°;

  • Dual GRs with more frequent lengthening seem to offer better results than a single GR because of their greater ability to control the spine;

  • Children with thoracic insufficiency syndrome should have the option of VEPTR treatment;

  • A short anterior and posterior apical fusion should be avoided because it seems to adversely affect the long-term results with respect to correction of the spinal deformity and spinal growth, and may result in an increased incidence of complications.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.