Decade-Long Progress of a Patient with Early Onset Scoliosis Treated with Serial Casting, Traditional Growth Rods and Posterior Spinal Instrumentation with Fusion – a Case Report

Document Type : CASE REPORT

Authors

Department of Orthopaedics and Traumatology, Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia

10.22038/abjs.2025.87025.3954

Abstract

Early-onset scoliosis poses unique challenges for spinal and paediatric surgeons, as well as clinicians. Without intervention in paediatric patients, the spinal curvature may worsen, leading to abnormal thoracic cage growth, leading to abnormal lung development and poor respiratory tolerance. Treatment aims to correct the deformity while preserving the spinal mobility during growth. This is important because the growing spine will allow the child to achieve optimal height, a healthy thoracic cage, and cardiopulmonary system development. We can divide treatment modalities into observation, serial casting, bracing, and surgery. We are presenting a decade long progress report of a patient who initially underwent treatment with serial casting, growing rods, and definitive fixation for early-onset scoliosis. We strive to illustrate the complexities of early-onset scoliosis treatment by progressing from bracing to the application of a growth-friendly rod system, and finally to definitive posterior instrumentation.
        Level of evidence: IV

Keywords

Main Subjects

References

  1. El-Hawary R, Akbarnia BA. Early onset scoliosis-time for consensus. Spine Deform. 2015;3(2):105-106. doi: 10.1016/j.jspd.2015.01.003.
  2. Ballhause TM, Moritz M, Hättich A, Stücker R, Mladenov K. Serial casting in early onset scoliosis: syndromic scoliosis is no contraindication. BMC Musculoskelet Disord. 2019;20(1):554. doi: 10.1186/s12891-019-2938-9.
  3. Ashebo L, Anari JB, Cahill PJ. Update on the diagnosis and management of early-onset scoliosis. Curr Rev Musculoskelet Med. 2023;16(10):447-456. doi: 10.1007/s12178-023-09848-w.
  4. 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(16):1359-67. doi: 10.2106/JBJS.M.00253.
  5. Roberts SB, Tsirikos AI. Factors influencing the evaluation and management of neuromuscular scoliosis: a review of the literature. J Back Musculoskelet Rehabil. 2016;29(4):613-623. doi: 10.3233/BMR-160675.
  6. Beauchamp EC, Anderson RC, Vitale MG. Modern surgical management of early onset and adolescent idiopathic scoliosis. Neurosurgery. 2019;84(2):291-304. doi: 10.1093/neuros/nyy267.
  7. Pehrsson K, Larsson S, Oden A, Nachemson A. Long-term follow-up of patients with untreated scoliosis a study of mortality, causes of death, and symptoms. Spine. Spine (Phila Pa 1976). 1992;17(9):1091-6. doi: 10.1097/00007632-199209000-00014.
  8. Dunnill MS. Postnatal growth of the lung. Thorax. 1962;17(4):329.
  9. Branthwaite MA. Cardiorespiratory consequences of unfused idiopathic scoliosis. Br J Dis Chest. 1986;80(4):360-9. doi: 10.1016/0007-0971(86)90089-6.
  10. Bradford EH, Brackett EG. Treatment of lateral curvature by means of pressure correction. The Boston Medical and Surgical Journal. 1893;128(19):463-8.
  11. Mehta MH. Growth as a corrective force in the early treatment of progressive infantile scoliosis. J Bone Joint Surg Br. 2005;87(9):1237-47. doi: 10.1302/0301-620X.87B9.16124.
  12. Canavese F, Samba A, Dimeglio A, Mansour M, Rousset M. Serial elongation-derotation-flexion casting for children with early-onset scoliosis. World J Orthop. 2015;6(11):935-43. doi: 10.5312/wjo.v6.i11.935.
  13. Mehta JS, Tognini M, Hothi H. Growing rods in Early Onset Scoliosis: The current scenario. J Orthop. 2023:42:63-69. doi: 10.1016/j.jor.2023.07.008.
  14. Ahmad AA. Early onset scoliosis and current treatment methods. J Clin Orthop Trauma. 2020;11(2):184-190. doi: 10.1016/j.jcot.2019.12.011.
  15. Wang S, Pu X, Sun X, Wang B, Zhu Z, Qiu Y. Optimal timing of starting growing rod treatment for early-onset scoliosis. Spine J. 2024;24(9):1750-1758. doi: 10.1016/j.spinee.2024.04.005.
  16. 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(15):2533-43. doi: 10.2106/JBJS.I.01471.
  17. Srivastava A, Gupta A, Hanasoge V, Jayaswal A. Complications of growing rod technique for early onset scoliosis. Indian Spine Journal. 2023;6(1):27-36.
  18. Latalski M, Fatyga M, Sowa I, Wojciak M, Starobrat G, Danielewicz A. Complications in growth-friendly spinal surgeries for early-onset scoliosis: literature review. World J Orthop. 2021;12(8):584-603. doi: 10.5312/wjo.v12.i8.584.
  19. Pizones J, Martín-Buitrago MP, Márquez JM, Fernández-Baíllo N, Baldan-Martin M, Pérez-Grueso FJ. Decision making of graduation in patients with early-onset scoliosis at the end of distraction-based programs: risks and benefits of definitive fusion. Spine Deform. 2018;6(3):308-313. doi: 10.1016/j.jspd.2017.10.005.

 

 

 

The Archives of Bone and Joint Surgery
Volume 14, Issue 2
February 2026
Pages 159-164

Files

History

  • Receive Date: 09 April 2025
  • Revise Date: 31 January 2026
  • Accept Date: 23 June 2025

Share

How to cite

Statistics