Systematic Reviews
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Aug 18, 2021; 12(8): 584-603
Published online Aug 18, 2021. doi: 10.5312/wjo.v12.i8.584
Complications in growth-friendly spinal surgeries for early-onset scoliosis: Literature review
Michał Latalski, Marek Fatyga, Ireneusz Sowa, Magdalena Wojciak, Grzegorz Starobrat, Anna Danielewicz
Michał Latalski, Anna Danielewicz, Children Orthopaedic Department, Medical University of Lublin, Lublin 20-093, Poland
Marek Fatyga, Grzegorz Starobrat, Children Orthopaedic Department, University Hospital for Children, Lublin 20-093, Poland
Ireneusz Sowa, Magdalena Wojciak, Department of Analytical Chemistry, Medical University of Lublin, Lublin 20-093, Poland
Author contributions: Latalski M and Danielewicz A designed the research, performed literature research, analyzed the data, drafted, revised, and supervised the manuscript; Starobrat G and Fatyga M performed literature research, analyzed the data, drafted, revised the manuscript; Sowa I and Wojciak M analyzed the data, drafted, revised the manuscript; all authors have read and agreed to the published version of the manuscript.
Conflict-of-interest statement: The authors declare that there is no conflict of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Michał Latalski, MD, PhD, Professor, Children Orthopaedic Department, Medical University of Lublin, Gebali 6, Lublin 20-093, Poland. michallatalski@umlub.pl
Received: February 25, 2021
Peer-review started: February 25, 2021
First decision: March 31, 2021
Revised: April 12, 2021
Accepted: August 2, 2021
Article in press: August 2, 2021
Published online: August 18, 2021
Processing time: 167 Days and 3.6 Hours
ARTICLE HIGHLIGHTS
Research background

The treatment for early-onset scoliosis (EOS) remains a great challenge for pediatric orthopedics. The treatment goals for EOS, regardless of the diagnosis, are the same: minimizing spinal deformity while maximizing thoracic volume and pulmonary function. When conservative treatment is ineffective, the option is surgery.

Research motivation

Different surgical techniques have different advantages and drawbacks. Those most often used are traditional growing rods (TGR), vertical expandable prosthetic titanium ribs (VEPTR), magnetically controlled growing rods (MCGR), and the Shilla growth guidance system (SGGS). Repeated surgeries and complications are two major concerns in EOS management.

Research objectives

The aim of the study was to review the current literature to assess the safety of EOS surgical treatment in terms of the rate of complications and unplanned surgeries.

Research methods

The systematic review was conducted according to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. In January 2021, a search of three electronic medical databases (PubMed, the Cochrane Library, and Embase) was performed by three independent authors. We combined the terms: “early-onset scoliosis” OR “eos” OR “juvenile scoliosis” OR “infantile scoliosis” OR “tgr” OR “veptr” OR “MCGR” OR “Shilla” OR “growth-friendly” AND “complication”.

Research results

EOS surgery has a varying but high rate of complications. The most frequent complications were categorized as implant, general, wound and alignment. The rate of complications might have been even higher than reported, as some authors do not report all types of complications.

Research conclusions

The literature concerning the definitions, collection, and interpretation of data regarding EOS surgery complications is often difficult to interpret. This creates problems in the comparison, analysis, and improvement of spine surgery practice. Awareness of the high rate of complications of EOS surgery is crucial, and an optimal strategy for prevention should become a priority.

Research perspectives

This observation indicates that data on the incidence of complications can be underestimated, and should be interpreted with caution. Further studies are needed to confirm the study results, especially concerning longitudinal data.