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What’s New in Pediatric Spine Growth Modulation and Implant Technology for Early-Onset Scoliosis?

Wessell, Nolan, M., MD*; Martus, Jeffrey, E., MD; Halanski, Matthew, A., MD; Snyder, Brian, MD, PhD§; Truong, Walter, MD∥,¶

Journal of Pediatric Orthopaedics: January 2018 - Volume 38 - Issue 1 - p e3–e13
doi: 10.1097/BPO.0000000000000830
POSNA Review Articles

Background: Early-onset scoliosis (EOS) affects roughly 1 to 2 out of 10,000 live births per year. Because this subset of patients has a yet to achieve a majority of their skeletal growth, a number of treatment challenges need to be addressed before surgical intervention. If left untreated, EOS can cause a number of problems throughout the patient’s lifespan, particularly in regards to the growth of the thorax and pulmonary development. A wide variety of surgical systems and techniques are available to the treating surgeon.

Methods: A review of the orthopaedic literature from 2010 to 2015 relating to pediatric spine growth modulation was performed. Ninety-eight papers were identified and, following exclusion criteria, a total of 31 papers were selected for further review.

Results: This paper summarizes the recently published literature regarding growth-friendly spinal implants, the status of their Food and Drug Administration approval labeling as well as the indications, applications, and complications associated with their implementation.

Conclusions: There are a growing number of options at the surgeon’s disposal when treating patients with EOS. As surgeons, we must continue to be vigilant in our demand for sound clinical evidence as we strive to provide optimal care for our patients. The rapidly advancing field of spinal growth modulation is exciting. More work must be done to further enhance our ability to predictably modulate growth in the pediatric spine.

*Department of Orthopaedic Surgery, Henry Ford Health System, Detroit, MI

Vanderbilt University School of Medicine, Nashville, TN

University of Wisconsin School of Medicine & Public Health, Madison, WI

§Boston Children’s Hospital, Harvard Medical School, Boston, MA

Gillette Children’s Specialty Healthcare, St Paul

Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN

None of the authors received financial support for the production of this manuscript.

M.A.H. has received implant donations from Medtronic Inc. for previous studies unrelated to the work contained herein. W.T. has previously received a 1-day travel stipend from DePuy/Synthes to observe live operative demonstrations. The other authors declare no conflicts of interest.

Reprints: Nolan M. Wessell, MD, Department of Orthopaedic Surgery, Henry Ford Health System, 2799 W. Grand Blvd, CFP-6, Detroit, MI 48202. E-mail: nwessel1@hfhs.org.

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