Ashebo Leta, Anari Jason B, Cahill Patrick J
Division of Orthopaedics, Children's Hospital of Philadelphia, 3500 Civic Center Blvd, Philadelphia, PA, 19142, USA.
Curr Rev Musculoskelet Med. 2023 Oct;16(10):447-456. doi: 10.1007/s12178-023-09848-w. Epub 2023 Aug 24.
In this article, we review the most recent advancements in the approaches to EOS diagnosis and assessment, surgical indications and options, and basic science innovation in the space of early-onset scoliosis research.
Early-onset scoliosis (EOS) covers a diverse, heterogeneous range of spinal and chest wall deformities that affect children under 10 years old. Recent efforts have sought to examine the validity and reliability of a recently developed classification system to better standardize the presentation of EOS. There has also been focused attention on developing safer, informative, and readily available imaging and clinical assessment tools, from reduced micro-dose radiographs, quantitative dynamic MRIs, and pulmonary function tests. Basic science innovation in EOS has centered on developing large animal models capable of replicating scoliotic deformity to better evaluate corrective technologies. And given the increased variety in approaches to managing EOS in recent years, there exist few clear guidelines around surgical indications across EOS etiologies. Despite this, over the past two decades, there has been a considerable shift in the spinal implant landscape toward growth-friendly instrumentation, particularly the utilization of MCGR implants. With the advent of new biological and basic science treatments and therapies extending survivorship for disease etiologies associated with EOS, the treatment for EOS has steadily evolved in recent years. With this has come a rising volume and variation in management options for EOS, as well as the need for multidisciplinary and creative approaches to treating patients with these complex and heterogeneous disorders.
在本文中,我们回顾了早发性脊柱侧弯(EOS)诊断与评估方法、手术适应症与选择以及该领域基础科学创新方面的最新进展。
早发性脊柱侧弯(EOS)涵盖了一系列影响10岁以下儿童的多样、异质性的脊柱和胸壁畸形。近期研究致力于检验一种新开发的分类系统的有效性和可靠性,以更好地规范EOS的表现形式。人们还集中关注开发更安全、信息丰富且易于获得的成像和临床评估工具,包括减少微剂量X线片、定量动态磁共振成像和肺功能测试。EOS的基础科学创新主要集中在开发能够复制脊柱侧弯畸形的大型动物模型,以更好地评估矫正技术。鉴于近年来EOS治疗方法的多样性增加,针对EOS各种病因的手术适应症几乎没有明确的指导方针。尽管如此,在过去二十年中,脊柱植入物领域已发生了相当大的转变,朝着有利于生长的器械发展,尤其是MCGR植入物的应用。随着新的生物和基础科学治疗方法的出现,以及与EOS相关疾病病因的生存期延长,近年来EOS的治疗方法不断发展。随之而来的是EOS管理选择的数量增加和变化,以及需要采用多学科和创造性方法来治疗这些复杂和异质性疾病的患者。