Pediatric Spine Foundation

Title: An initial effort to define an early onset scoliosis “graduate”—The Pediatric Spine Study Group experience

Authors: Christina K. Hardesty, Robert F. Murphy, Jef B. Pawelek, Michael P. Glotzbecker, Pooria Hosseini, Charles E. Johnston, John Means, Behrooz A. Akbarnia, The Pediatric Spine Study Group

Journal: Spine Deformity

Date: November 30, 2020

Excerpt: Increasingly, patients with early onset scoliosis (EOS) are completing a growth friendly surgical treatment followed by observation, removal of implants or a definitive spinal fusion. As treatment is completed, these patients are referred to as “graduates”. A standardized definition of a graduate is needed for research and comparing the outcomes, family counseling, and a better understanding of the population.

Keywords: Early-onset scoliosis, Graduate, Scoliosis, Spinal deformity

Summary:

Purpose

Patients who have completed surgical treatment for Early Onset Scoliosis (EOS) are known as "graduates". This paper aims to provide a standardized definition of an EOS "graduate" to better compare patient outcomes and define what can be considered successful treatment.

Results

  • Results from surveys completed by industry professionals defined a "graduate" as a patient who has undergone any surgical program to treat early onset scoliosis and has reached skeletal maturity with no plans for a related surgical intervention in the future. More than 80% of study participants agreed upon this final definition.
  • Skeletal maturity was determined to be the most important factor in defining a graduate. Therefore, patients must reach skeletal maturity to be considered an EOS graduate.
  • The results from the survey found that EOS patients do not need to have a final fusion to complete growth-friendly treatment and become a graduate. (87% consensus)

Discussion Points

  • Since this definition must account for improvements in technology, many treatment types, time, and patient circumstances, skeletal maturity is the best choice for measurement of a graduate, as it is a constant measure that best fits all circumstances of treatment of EOS.
  • This consensus definition of an EOS graduate allows for standardized research, provides better understanding of the challenging and heterogeneous population of EOS patients, and provides surgeons with information for counseling families.