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- W2017485816 abstract "The prognosis of children with progressive early onset scoliosis has improved considerably due to recent advances in surgical and non-surgical techniques and the understanding of the importance of preserving the thoracic space. The existing techniques and development of new methods have considerably improved the management of this condition. Derotational casting can be considered in children with documented progression of a <60° curve without previous surgical treatment. Both single and dual growing rods are effective, but the latter seem to offer better results. Hybrid constructs may be a better option in children who require a low-profile proximal anchor. The vertical expandable prosthetic titanium rib (VEPTR®) appears to be beneficial for patients with congenital scoliosis and fused ribs, and thoracic Insufficiency Syndrome. Children with medical comorbidities who may not tolerate repeated lengthenings should be considered for Shilla or Luque Trolley technique. Growth modulation using shape memory alloy staples or other tethers seem promising for mild curves, although more research is required to define their precise indications. El pronóstico de los niños con escoliosis de aparición precoz progresiva ha mejorado considerablemente gracias a los recientes avances en las técnicas quirúrgicas y no quirúrgicas, y al reconocimiento de la trascendencia de preservar la cavidad torácica. La mejora de técnicas ya existentes y el desarrollo de otras nuevas han modificado sustancialmente el tratamiento de esta entidad. Los yesos derrotatorios pueden indicarse en niños con curvas < 60° y progresión constatada, a los que no se ha realizado tratamiento quirúrgico previo. Tanto los tallos de crecimiento únicos como dobles son eficaces, aunque los últimos parecen ofrecer un mejor resultado. Los sistemas híbridos se plantean como mejor opción en niños que requieren un anclaje proximal con un perfil bajo. El vertical expandable prosthetic titanium rib (VEPTR®) puede ser útil en pacientes que presentan escoliosis congénita con fusiones costales y síndrome de insuficiencia torácica asociado. Los niños no tributarios de elongaciones repetidas por sus comorbilidades pueden ser candidatos a una técnica de Shilla o trolley de Luque. La modulación del crecimiento utilizando grapas de memoria o tirantes resulta prometedora en curvas menores, aunque se requieren más trabajos para definir su indicación precisa." @default.
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- W2017485816 date "2013-09-01" @default.
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- W2017485816 title "Early onset scoliosis. What are the options?" @default.
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- W2017485816 doi "https://doi.org/10.1016/j.recote.2013.05.001" @default.
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