Many Risks Related to Early Onset Scoliosis Treatments

Surgically treating early onset scoliosis with growing rods or vertical expandable prosthetic titanium rib procedures may not fully control the deformity over a patient's entire growth period, and both procedures are beset with complications, according to a literature review published in the Dec. 1 issue of Spine.


FRIDAY, Dec. 3 (HealthDay News) -- Surgically treating early onset scoliosis (EOS) with growing rods (GR) or vertical expandable prosthetic titanium rib (VEPTR) procedures may not fully control the deformity over a patient's entire growth period, and both procedures are beset with complications, according to a literature review published in the Dec. 1 issue of Spine.

Behrooz A. Akbarnia, M.D., of the University of California San Diego in La Jolla, and John B. Emans, M.D., of Harvard Medical School in Boston, reviewed studies on EOS and the indications, complications, and outcomes of GR and VEPTR.

The researchers found that risks associated with GR included spontaneous spinal fusion and rod breakage. Risks associated with VEPTR included drifting rib attachments and chest wall scars. Potential adverse outcomes associated with the treatments included failure to prevent progressive deformity or thoracic insufficiency syndrome, a spine that is too short or stiff or an unacceptably deformed thorax, increased burden of care for families, and negative psychological consequences from repeated surgery. The authors note that neither technique reliably controls deformity over the full growth period.

"Consideration of the options must include a discussion of complications as they relate to GR or VEPTR. Families need to understand that there will be unexpected events such as rod breakage or loss of anchor points or need for revision or exchange, and these complications might cause the premature cessation of treatment of EOS," the authors write.