Sauri-Barraza J C
Centro Médico ABC, Ciudad de México. México.
Acta Ortop Mex. 2023 Mar-Apr;37(2):99-105.
Early-onset scoliosis corresponds to a group of heterogeneous spinal conditions that present before 10 years of age with a curvature in the coronal plane of 10° or more. Regardless of the etiology, adequate control of the deformity is required to avoid cardiopulmonary deterioration and preserve quality and life expectancy. Diagnosis can be difficult and is usually incidental at a young age. To choose the best treatment, it is important to consider the patient's age, etiology, and rate of progression. Among the non-operative treatments, the most effective are the use of serial casts or brace, whose main objective is to stop the progression of the deformity and thus delay surgical treatment. Among the surgical treatments the distraction based systems and definitive arthrodesis have proven to be most effective. Early surgery leads to multiple complications, which is why, if feasible, non surgical management should be sought and fusion postponed till skeletal maturity. Due to the life-threatening risks associated with the deformity and treatment, it is important to educate the patient and family members about the importance of treatment adherence and follow-up.
早发性脊柱侧弯是指一组异质性脊柱疾病，这些疾病在10岁之前出现，冠状面弯曲度达10°或以上。无论病因如何，都需要对畸形进行充分控制，以避免心肺功能恶化，并维持生活质量和预期寿命。诊断可能存在困难，在患儿年幼时通常是偶然发现。为选择最佳治疗方法，考虑患者的年龄、病因和进展速度很重要。在非手术治疗中，最有效的是使用系列石膏或支具，其主要目的是阻止畸形进展，从而推迟手术治疗。在手术治疗中，撑开式系统和确定性关节融合术已被证明是最有效的。早期手术会导致多种并发症，这就是为什么在可行的情况下应寻求非手术治疗，并将融合手术推迟至骨骼成熟。由于与畸形及治疗相关的危及生命的风险，对患者及其家属进行治疗依从性和随访重要性的教育很重要。
