title: Updates on surgical treatments for pediatric scoliosis.
abstract: Scoliosis in children poses serious problems including respiratory problems, trunk imbalance, and depression, as well as detracting from the child's appearance. Scoliosis can also contribute to back pain later in life. Advanced surgical techniques allow for good correction and maintenance of progressive curves, and growth-sparing treatments are now available for patients with early-onset scoliosis (EOS). Posterior corrective surgeries using pedicle screw (PS) constructs, which allow curves to be corrected in three dimensions, has become the most popular surgical treatment for scoliosis. Several navigation systems and probes have been developed to aid in accurate PS placement. For thoracolumbar and lumbar curves, anterior surgery remains the method of choice. Growth-sparing techniques for treating EOS include growing rods, the Shilla method, anterior stapling, and vertical expandable prosthetic titanium rib, which was originally designed to treat thoracic insufficiency syndrome. However, these advanced surgical techniques do not always offer a perfect solution for pediatric scoliosis, and they are associated with complications such as infections and problems with instrumentation. Surgeons have developed several techniques in efforts to address these complications. We here review historic and recent advances in the surgical treatment of scoliosis in children, the problems associated with various techniques, and the challenges that remain to be overcome.
authors.affiliation: Department of Orthopedic Surgery, Keio University, Shinanomachi 35, Shinjuku, Tokyo, 160-8582, Japan, morio@a5.keio.jp.
authors.forename: Morio
authors.initials: M
authors.lastname: Matsumoto
authors.forename: Kota
authors.initials: K
authors.lastname: Watanabe
authors.forename: Naobumi
authors.initials: N
authors.lastname: Hosogane
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Toyama
mesh_terms: D002648:Child; D006801:Humans; D016268:Internal Fixators; D008159:Lumbar Vertebrae / Q000601:surgery*; D012600:Scoliosis / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods*; D013904:Thoracic Vertebrae / Q000601:surgery*