Congenital Scoliosis

Area of Science:

• Orthopedics
• Spinal Surgery
• Pediatric Deformity

Background:

• Congenital scoliosis involves spinal and rib malformations, often treated surgically before age three.
• Previous reviews found no evidence supporting early surgical intervention for congenital scoliosis.
• This review updates the evidence search for studies published between 2011 and March 2015.

Purpose of the Study:

• To conduct an updated literature search for evidence supporting early surgical intervention in congenital scoliosis.
• To evaluate the evidence-based nature of spinal fusion surgery for congenital scoliosis.
• To assess the safety and efficacy of current surgical techniques and alternative treatments.

Main Methods:

• Systematic literature review of studies published from 2011 to March 2015.
• Focused search for prospective and randomized controlled trials on congenital scoliosis treatment.
• Analysis of data regarding surgical outcomes, complications, and conservative management.

Main Results:

• No prospective or randomized controlled studies were found to support early spinal fusion as evidence-based treatment.
• Conflicting results exist regarding the safety of hemivertebra resection and pedicle screw fixation.
• High complication rates are associated with the VEPTR (vertical expandable prosthetic titanium rib) device.

Conclusions:

• There is a lack of evidence supporting early spinal fusion surgery for congenital scoliosis.
• Conservative management, including advanced bracing, may allow many patients to avoid surgery.
• Prioritizing conservative approaches before considering surgical intervention is recommended for congenital scoliosis.