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Evidence basis for management of spine and chest wall deformities in children

Paul D Sponseller1, Muharrem Yazici, Constantine Demetracopoulos

  • 1Johns Hopkins Medical Institutions, Baltimore, MD, USA. psponse@jhmi.edu

Spine
|September 6, 2007
PubMed

Insights

Research on spinal and chest wall deformities highlights the need for more evidence-based studies. Current treatments lack robust data due to rare and heterogeneous conditions affecting spinal growth.

Area of Science:

  • Pediatric Orthopedics
  • Thoracic Surgery
  • Developmental Biology

Background:

  • Knowledge of spinal, chest wall, and lung growth in normal and deformity states has evolved across specialties.
  • Interdisciplinary interest has grown with advancements in assessment and treatment tools.
  • Emergence of spine-based, chest wall-based, resection, and gradual distraction treatment options.

Purpose of the Study:

  • To review research on the growth of the spine and chest wall.
  • To examine the treatment of associated deformities.
  • To contextualize findings within evidence-based assessment frameworks.

Main Methods:

  • Systematic review of peer-reviewed research on spinal, lung, and chest wall growth and deformity treatment.
  • Comparison of various treatment modalities and their outcomes.
  • Assessment and ranking of evidence levels where feasible.

Main Results:

  • Most studies are Level III or IV (case-control, case series) due to the rarity and heterogeneity of disorders.
  • The natural history of most spinal/chest wall deformities is not accurately known.
  • Experimental evidence informs some growth-modulating spine treatments, but accurate deformity models are lacking.
  • Advancements in imaging and measurement enhance patient comparison capabilities.

Conclusions:

  • Significant opportunities exist for further evidence-based research into the natural history and treatment outcomes of spinal and chest wall deformities.
Abstract

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