An Overview of the Current State of Pediatric Scoliosis Management

Julian M. Rüwald; Robin L. Eymael; Janis Upenieks; Li Zhang; Cornelius Jacobs; Robert Pflugmacher; Frank A. Schildberg

doi:10.1055/a-0965-7760

Zeitschrift für Orthopädie und Unfallchirurgie, Table of Contents

Z Orthop Unfall 2020; 158(05): 508-516
DOI: 10.1055/a-0965-7760

Review

An Overview of the Current State of Pediatric Scoliosis Management

Eine Zusammenfassung des aktuellen Managements pädiatrischer Skoliose

Julian M. Rüwald

¹Clinic for Orthopedics and Trauma Surgery, University Hospital Bonn

,

Robin L. Eymael

²Medical Faculty, University Hospital Essen

,

Janis Upenieks

³Department of Pediatric Surgery, University Childrenʼs Hospital, Riga, Latvia

,

Li Zhang

¹Clinic for Orthopedics and Trauma Surgery, University Hospital Bonn

,

Cornelius Jacobs

¹Clinic for Orthopedics and Trauma Surgery, University Hospital Bonn

,

Robert Pflugmacher

¹Clinic for Orthopedics and Trauma Surgery, University Hospital Bonn

,

Frank A. Schildberg

¹Clinic for Orthopedics and Trauma Surgery, University Hospital Bonn

› Author Affiliations

Abstract

Historically pediatric scoliosis represents a condition deeply rooted within the origins of orthopedic surgery. Today only a few subspecialized surgeons treat pediatric scoliosis patients. In severe cases surgery can hold progression of and correct pathologic spinal curvature. The goal of this article is to provide an overview of the current state of pediatric scoliosis management. It aims to increase the attention of general physicians and orthopedic surgeons to a niched but rather frequently encountered pediatric pathology to facilitate early recognition and diagnosis. A thorough research of literature was conducted to summarize the different scoliosis types, their etiology and presentation. Classification, normal human growth phases and curve progression risk have been further elaborated. Finally, current treatment options with their benefits, shortcomings and complications were laid out and discussed. Among the etiological groups a focus was put on idiopathic scoliosis, in particular adolescent idiopathic scoliosis as the most frequently encountered subtype.

Zusammenfassung

Historisch ist die pädiatrische Skoliose eine Erkrankung, die tief in den Ursprüngen der orthopädischen Chirurgie verwurzelt ist. Heute behandeln nur wenige subspezialisierte Orthopäden Patienten mit dieser Erkrankung. In ausgeprägten Fällen kann eine Operation das Fortschreiten der Erkrankung aufhalten und die pathologische Krümmung der Wirbelsäule korrigieren. Diese Übersichtsarbeit soll einen Überblick über den aktuellen Stand des pädiatrischen Skoliose-Managements geben. Ziel ist es, die Aufmerksamkeit von Allgemeinärzten und Orthopäden auf eine spezielle, jedoch häufig auftretende pädiatrische Pathologie zu richten, um eine frühzeitige Erkennung und Diagnose zu erleichtern. In einer gründlichen Literaturrecherche wurden die verschiedenen Skoliose-Typen, ihre Ätiologie und ihre Manifestation zusammengefasst. Die zugehörige Klassifizierung, reguläre Wachstumsphasen und das Risiko der Kurvenprogression wurden näher ausgearbeitet. Abschließend wurden aktuelle Behandlungsmöglichkeiten mit ihren Vorteilen, Mängeln und Komplikationen dargelegt und diskutiert. Bei den ätiologischen Gruppen lag der Schwerpunkt auf der idiopathischen Skoliose, insbesondere der adoleszenten idiopathischen Skoliose als am häufigsten anzutreffendem Subtyp.

Key words

pediatric scoliosis management - adolescent idiopathic scoliosis - current review

Schlüsselwörter

pädiatrische Skoliose - adoleszente idiopathische Skoliose - aktuelle Übersicht

Full Text

References

References
1 Huec JCL, Jouve JL, Szpalski M. Surgical techniques in pediatric spine surgery. Eur Spine J 2014; 23: 395-396
2 Hasler CC. A brief overview of 100 years of history of surgical treatment for adolescent idiopathic scoliosis. J Child Orthop 2013; 7: 57-62
3 Cheng JC, Castelein RM, Chu WC. et al. Adolescent idiopathic scoliosis. Nat Rev Dis Primers 2015; 1: 15030
4 Sud A, Tsirikos AI. Current concepts and controversies on adolescent idiopathic scoliosis: Part I. Indian J Orthop 2013; 47: 117-128
5 Kim H, Kim HS, Moon ES. et al. Scoliosis imaging: what radiologists should know. Radiographics 2010; 30: 1823-1842
6 Negrini S, Donzelli S, Aulisa AG. et al. 2016 SOSORT guidelines: orthopaedic and rehabilitation treatment of idiopathic scoliosis during growth. Scoliosis Spinal Disord 2018; 13: 3
7 Perdriolle R, Vidal J. Morphology of scoliosis: three-dimensional evolution. Orthopedics 1987; 10: 909-915
8 Choudhry MN, Ahmad Z, Verma R. Adolescent Idiopathic Scoliosis. Open Orthop J 2016; 10: 143-154
9 El-Hawary R, Chukwunyerenwa C. Update on evaluation and treatment of scoliosis. Pediatr Clin North Am 2014; 61: 1223-1241
10 Janicki JA, Alman B. Scoliosis: Review of diagnosis and treatment. Paediatr Child Health 2007; 12: 771-776
11 James JI. Idiopathic scoliosis; the prognosis, diagnosis, and operative indications related to curve patterns and the age at onset. J Bone Joint Surg Br 1954; 36-B: 36-49
12 Thompson SK, Bentley G. Prognosis in infantile idiopathic scoliosis. J Bone Joint Surg Br 1980; 62-B: 151-154
13 Skaggs DL, Guillaume T, El-Hawary R. et al. Early Onset Scoliosis Consensus Statement, SRS Growing Spine Committee, 2015. Spine Deform 2015; 3: 107
14 Mehta MH. Growth as a corrective force in the early treatment of progressive infantile scoliosis. J Bone Joint Surg Br 2005; 87-B: 1237-1247
15 Aulisa AG, Guzzanti V, Marzetti E. et al. Brace treatment in juvenile idiopathic scoliosis: a prospective study in accordance with the SRS criteria for bracing studies – SOSORT award 2013 winner. Scoliosis 2014; 9: 3
16 Weinstein SL, Dolan LA, Cheng JC. et al. Adolescent idiopathic scoliosis. Lancet 2008; 371: 1527-1537
17 El-Hawary R, Akbarnia BA. Early Onset Scoliosis – Time for Consensus. Spine Deform 2015; 3: 105-106
18 Fletcher ND, Bruce RW. Early onset scoliosis: current concepts and controversies. Curr Rev Musculoskelet Med 2012; 5: 102-110
19 Asher MA, Burton DC. Adolescent idiopathic scoliosis: natural history and long term treatment effects. Scoliosis 2006; 1: 2
20 Weiss H-R, Karavidas N, Moramarco M. et al. Long-Term Effects of Untreated Adolescent Idiopathic Scoliosis: A Review of the Literature. Asian Spine J 2016; 10: 1163-1169
21 Du Q, Zhou X, Negrini S. et al. Scoliosis epidemiology is not similar all over the world: a study from a scoliosis school screening on Chongming Island (China). BMC Musculoskelet Disord 2016; 17: 303
22 Carter OD, Haynes SG. Prevalence rates for scoliosis in US adults: results from the first National Health and Nutrition Examination Survey. Int J Epidemiol 1987; 16: 537-544
23 Aebi M. The adult scoliosis. Eur Spine J 2005; 14: 925-948
24 Schwab F, Dubey A, Gamez L. et al. Adult scoliosis: prevalence, SF-36, and nutritional parameters in an elderly volunteer population. Spine (Phila Pa 1976) 2005; 30: 1082-1085
25 Konieczny MR, Senyurt H, Krauspe R. Epidemiology of adolescent idiopathic scoliosis. J Child Orthop 2013; 7: 3-9
26 Debnath UK, Goel V, Harshavardhana N. et al. Congenital scoliosis – Quo vadis?. Indian J Orthop 2010; 44: 137-147
27 Berven S, Bradford DS. Neuromuscular scoliosis: causes of deformity and principles for evaluation and management. Semin Neurol 2002; 22: 167-178
28 Hoashi JS, Cahill PJ, Bennett JT. et al. Adolescent scoliosis classification and treatment. Neurosurg Clin N Am 2013; 24: 173-183
29 Grauers A, Einarsdottir E, Gerdhem P. Genetics and pathogenesis of idiopathic scoliosis. Scoliosis Spinal Disord 2016; 11: 45
30 Andersen MO, Thomsen K, Kyvik KO. Adolescent idiopathic scoliosis in twins: a population-based survey. Spine (Phila Pa 1976) 2007; 32: 927-930
31 Kesling KL, Reinker KA. Scoliosis in twins. A meta-analysis of the literature and report of six cases. Spine (Phila Pa 1976) 1997; 22: 2009-2014 discussion 2015
32 Paria N, Wise CA. Genetics of adolescent idiopathic scoliosis. Semin Spine Surg 2015; 27: 9-15
33 Ward K, Ogilvie J, Argyle V. et al. Polygenic inheritance of adolescent idiopathic scoliosis: A study of extended families in Utah. Am J Med Genet A 2010; 152 A: 1178-1188
34 Weinstein SL, Dolan LA, Cheng JC. et al. Adolescent idiopathic scoliosis. Lancet 2008; 371: 1527-1537
35 Wajchenberg M, Astur N, Kanas M. et al. Adolescent idiopathic scoliosis: current concepts on neurological and muscular etiologies. Scoliosis Spinal Disord 2016; 11: 4
36 Williams BA, Matsumoto H, McCalla DJ. et al. Development and initial validation of the Classification of Early-Onset Scoliosis (C-EOS). J Bone Joint Surg Am 2014; 96: 1359-1367
37 Arlet V, Odent T, Aebi M. Congenital scoliosis. Eur Spine J 2003; 12: 456-463
38 Hensinger RN. Congenital Scoliosis: Etiology and Associations. Spine (Phila Pa 1976) 2009; 34: 1745
39 Farley FA. Etiology of Congenital Scoliosis. Semin Spine Surg 2010; 22: 110-112
40 Burnei G, Gavriliu S, Vlad C. et al. Congenital scoliosis: an up-to-date. J Med Life 2015; 8: 388-397
41 Vialle R, Thévenin-Lemoine C, Mary P. Neuromuscular scoliosis. Orthop Traumatol Surg Res 2013; 99: S124
42 Cloake T, Gardner A. The management of scoliosis in children with cerebral palsy: a review. J Spine Surg 2016; 2: 299-309
43 Tsirikos AI, Smith G. Scoliosis in patients with Friedreichʼs ataxia. J Bone Joint Surg Br 2012; 94-B: 684-689
44 Kinali M, Messina S, Mercuri E. et al. Management of scoliosis in Duchenne muscular dystrophy: a large 10-year retrospective study. Dev Med Child Neurol 2006; 48: 513-518
45 Prior TW, Finanger E. Spinal Muscular Atrophy. University of Washington, Seattle, 2016. Online (last access: 16.07.2019): https://www.ncbi.nlm.nih.gov/sites/books/NBK1352/
46 Mulcahey MJ, Gaughan JP, Betz RR. et al. Neuromuscular Scoliosis in Children with Spinal Cord Injury. Top Spinal Cord Inj Rehabil 2013; 19: 96-103
47 Allam AM, Schwabe AL. Neuromuscular scoliosis. PM R 2013; 5: 957-963
48 Halawi MJ, Lark RK, Fitch RD. Neuromuscular Scoliosis: Current Concepts. Orthopedics 2015; 38: e452-e456
49 Levy BJ, Schulz JF, Fornari ED. et al. Complications associated with surgical repair of syndromic scoliosis. Scoliosis 2015; 10: 14
50 Busscher I, Kingma I, Bruin R. et al. Predicting the peak growth velocity in the individual child: validation of a new growth model. Eur Spine J 2012; 21: 71-76
51 Busscher I, Wapstra FH, Veldhuizen AG. Predicting growth and curve progression in the individual patient with adolescent idiopathic scoliosis: design of a prospective longitudinal cohort study. BMC Musculoskelet Disord 2010; 11: 93
52 Sanders JO. Normal growth of the spine and skeletal maturation. Semin Spine Surg 2015; 27: 16-20
53 Chulani VL, Gordon LP. Adolescent Growth and Development. Prim Care 2014; 41: 465-487
54 Granados A, Gebremariam A, Lee JM. Relationship Between Timing of Peak Height Velocity and Pubertal Staging in Boys and Girls. J Clin Res Pediatr Endocrinol 2015; 7: 235-237
55 Mo F, Cunningham ME. Pediatric scoliosis. Curr Rev Musculoskelet Med 2011; 4: 175-182
56 Yang S, Andras LM, Redding GJ. et al. Early-Onset Scoliosis: A Review of History, Current Treatment, and Future Directions. Pediatrics 2016; 137: e20150709
57 Kotwicki T, Jozwiak M. Conservative management of neuromuscular scoliosis: personal experience and review of literature. Disabil Rehabil 2008; 30: 792-798
58 Marks DS, Qaimkhani SA. The natural history of congenital scoliosis and kyphosis. Spine (Phila Pa 1976) 2009; 34: 1751-1755
59 Horne JP, Flannery R, Usman S. Adolescent idiopathic scoliosis: diagnosis and management. Am Fam Physician 2014; 89: 193-198
60 Greiner AK. Adolescent Idiopathic Scoliosis: Radiologic Decision-Making. Am Fam Physician 2002; 65: 1817
61 Sanders JO, Khoury JG, Kishan S. et al. Predicting scoliosis progression from skeletal maturity: a simplified classification during adolescence. J Bone Joint Surg Am 2008; 90: 540-553
62 Sanders JO, Browne RH, McConnell SJ. et al. Maturity assessment and curve progression in girls with idiopathic scoliosis. J Bone Joint Surg Am 2007; 89: 64-73
63 Tan K-J, Moe MM, Vaithinathan R. et al. Curve progression in idiopathic scoliosis: follow-up study to skeletal maturity. Spine (Phila Pa 1976) 2009; 34: 697-700
64 Weinstein SL, Ponseti IV. Curve progression in idiopathic scoliosis. J Bone Joint Surg Am 1983; 65: 447-455
65 Miller NH. Cause and natural history of adolescent idiopathic scoliosis. Orthop Clin North Am 1999; 30: 343-352 vii
66 Lee CF, Fong DYT, Cheung KMC. et al. A new risk classification rule for curve progression in adolescent idiopathic scoliosis. Spine J 2012; 12: 989-995
67 Ward K, Ogilvie JW, Singleton MV. et al. Validation of DNA-based prognostic testing to predict spinal curve progression in adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 2010; 35: E1455-1464
68 Ogilvie JW. Update on prognostic genetic testing in adolescent idiopathic scoliosis (AIS). J Pediatr Orthop 2011; 31: S46-48
69 Weinstein SL, Dolan LA, Wright JG. et al. Effects of Bracing in Adolescents with Idiopathic Scoliosis. N Engl J Med 2013; 369: 1512-1521
70 Rolton D, Nnadi C, Fairbank J. Scoliosis: a review. Paediatr Child Health 2014; 24: 197-203
71 Canavese F, Kaelin A. Adolescent idiopathic scoliosis: Indications and efficacy of nonoperative treatment. Indian J Orthop 2011; 45: 7-14
72 Dolan LA, Weinstein SL. Surgical rates after observation and bracing for adolescent idiopathic scoliosis: an evidence-based review. Spine (Phila Pa 1976) 2007; 32: S91
73 MacLean WE, Green NE, Pierre CB. et al. Stress and coping with scoliosis: psychological effects on adolescents and their families. J Pediatr Orthop 1989; 9: 257-261
74 Falk B, Rigby WA, Akseer N. Adolescent idiopathic scoliosis: the possible harm of bracing and the likely benefit of exercise. Spine J 2015; 15: 1169-1171
75 Tsirikos AI, Miller F, Glutting J. Life expectancy in pediatric patients with cerebral palsy and neuromuscular scoliosis who underwent spinal fusion. Dev Med Child Neurol 2003; 45: 677-682
76 Suk S-I. Pedicle Screw Instrumentation for Adolescent Idiopathic Scoliosis: The Insertion Technique, the Fusion Levels and Direct Vertebral Rotation. Clin Orthop Surg 2011; 3: 89-100
77 Harrington PR. Treatment of scoliosis. Correction and internal fixation by spine instrumentation. J Bone Joint Surg Am 1962; 44-A: 591-610
78 Cotrel Y, Dubousset J, Guillaumat M. New universal instrumentation in spinal surgery. Clin Orthop 1988; 227: 10-23
79 Deniz Olgun Z, Yazici M. Posterior instrumentation and fusion. J Child Orthop 2013; 7: 69-76
80 Lin Y, Chen W, Chen A. et al. Anterior versus Posterior Selective Fusion in Treating Adolescent Idiopathic Scoliosis: A Systematic Review and Meta-Analysis of Radiologic Parameters. World Neurosurg 2018; 111: e830
81 Shapiro F, Sethna N. Blood loss in pediatric spine surgery. Eur Spine J 2004; 13: S6
82 Helenius I. Anterior surgery for adolescent idiopathic scoliosis. J Child Orthop 2013; 7: 63-68
83 Sucato DJ. Management of severe spinal deformity: scoliosis and kyphosis. Spine (Phila Pa 1976) 2010; 35: 2186-2192
84 Pizones J, Alvarez-González P, Sánchez-Mariscal F. et al. [Prognostic factors of the crankshaft phenomenon in patients with scoliosis and open triradiate cartilage. Is the double approach the solution?]. Rev Esp Cir Ortop Traumatol 2013; 57: 170-177
85 Chen Z, Rong L. Comparison of combined anterior-posterior approach versus posterior-only approach in treating adolescent idiopathic scoliosis: a meta-analysis. Eur Spine J 2016; 25: 363-371
86 Dohin B, Dubousset JF. Prevention of the crankshaft phenomenon with anterior spinal epiphysiodesis in surgical treatment of severe scoliosis of the younger patient. Eur Spine J 1994; 3: 165-168
87 Tao F, Zhao Y, Wu Y. et al. The effect of differing spinal fusion instrumentation on the occurrence of postoperative crankshaft phenomenon in adolescent idiopathic scoliosis. J Spinal Disord Tech 2010; 23: e75-80
88 Karol LA. Early Definitive Spinal Fusion in Young Children: What We Have Learned. Clin Orthop 2011; 469: 1323-1329
89 Bess S, Akbarnia BA, Thompson GH. et al. Complications of growing-rod treatment for early-onset scoliosis: analysis of one hundred and forty patients. J Bone Joint Surg Am 2010; 92: 2533-2543
90 Choi E, Yaszay B, Mundis G. et al. Implant Complications After Magnetically Controlled Growing Rods for Early Onset Scoliosis: A Multicenter Retrospective Review. J Pediatr Orthop 2017; 37: e588
91 Hickey BA, Towriss C, Baxter G. et al. Early experience of MAGEC magnetic growing rods in the treatment of early onset scoliosis. Eur Spine J 2014; 23: 61-65
92 Jenks M, Craig J, Higgins J. et al. The MAGEC system for spinal lengthening in children with scoliosis: A NICE Medical Technology Guidance. Appl Health Econ Health Policy 2014; 12: 587-599
93 McCarthy RE, McCullough FL. Shilla Growth Guidance for Early-Onset Scoliosis: Results After a Minimum of Five Years of Follow-up. J Bone Joint Surg Am 2015; 97: 1578-1584
94 Skaggs DL, Akbarnia BA, Flynn JM. et al. Chest Wall and Spine Deformity Study Group; Growing Spine Study Group; Pediatric Orthopaedic Society of North America; Scoliosis Research Society Growing Spine Study Committee. A classification of growth friendly spine implants. J Pediatr Orthop 2014; 34: 260-274
95 Luhmann SJ, Smith JC, McClung A. et al. Radiographic Outcomes of Shilla Growth Guidance System and Traditional Growing Rods Through Definitive Treatment. Spine Deform 2017; 5: 277-282
96 Yang JH, Ham CH, Hwang YG. et al. Metallosis: A Complication in the Guided Growing Rod System Used in Treatment of Scoliosis. Indian J Orthop 2017; 51: 714-718
97 Jain V, Lykissas M, Trobisch P. et al. Surgical aspects of spinal growth modulation in scoliosis correction. Instr Course Lect 2014; 63: 335-344