September 29, 2007

Spinal Fusion NOT Recommended Treatment for Early-Onset Scoliosis

Treatment for Early-Onset Scoliosis

While spinal fusion has been shown to improve quality of life and life expectancy in adolescents who have achieved normal pulmonary capacity before the onset of scoliosis, this treatment has quite a different result in skeletally immature children. In these patients, spinal fusion prevents growth of the spine and thorax during a critical developmental time – worsening lung function, and the quality of life and mortality issues associated with this syndrome. Surgeons at MSCHONY and other specialized centers, therefore, attempt to avoid spinal fusion in young children with early-onset scoliosis.

Growing Rods and VEPTR provide Better Outcomes

Treating early-onset scoliosis with growing rods and/or VEPTR permits continued growth of the spine, maximizes space available for lungs and enhances pulmonary function. By increasing pulmonary capacity as well as straightening the spine, these treatments provide significant quality of life improvements in the child’s ability to breathe, to talk, to live. Spinal fusion, by contrast, irreversibly limits growth of the patient’s spine, thorax and lungs. The resulting respiratory insufficiency has a progressive negative impact, starting with low vitality (the child tires easily, has trouble talking and eating). If the respiratory status deteriorates further, respiratory support may be required, and the risk of recurrent pneumonia increases along with mortality.

The complex care required by children diagnosed with early-onset scoliosis has tended to limit their treatment to children’s hospitals offering a convergence of strong orthopaedic, pulmonary and ICU facilities. Morgan Stanley Children’s Hospital of New York- Presbyterian’ orthopaedic teams have significant experience in applying these techniques and are continuing to develop and test techniques, and share in research, with the expectation of even better outcomes in the future.

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