Treatments & Procedures
How Do We Treat Early-Onset Scoliosis?
Many children with EOS have spinal curves that do not progress and do not require surgery, and we can treat them with close follow-up. For children whose spinal curves do get worse, we offer a number of treatment options. These children need early treatment to prevent deformities in the wall of the chest and to enable their lungs to develop normally.
In groundbreaking research we conducted in 2007, we determined that spinal fusion, once a standard practice for treating EOS, prevents growth of the spine and thorax during a critical period of a child's lung development. We therefore try to avoid spinal fusion in young children with EOS whenever possible, opting instead for treatments such as:
Casting For Infantile And Juvenile Scoliosis
- Very young children with scoliosis are often not candidates for surgery and in fact may not need surgery. We have state-of-the-art noninvasive treatments for these children.
- We may fit very young children, under age 3, with external casts every few months which enable them to move and play and may avoid the need for surgery.
- Our casting program for infantile idiopathic scoliosis utilizes an Amil casting frame and follows the techniques of Dr. Min Mehta to use growth as a corrective force to treat progressive infantile scoliosis.
VEPTR And Growing Rods
- Treating EOS with growing rods and/or the Vertical Expandable Prosthetic Titanium Rib (VEPTR) permits continued growth in the spine, maximizes the space available for your child's lungs, and enhances your child's lung function.
- VEPTR is an advanced treatment option for children with scoliosis who have thoracic insufficiency syndrome (TIS). These children have severe deformities in the chest, spine, and ribs that prevent normal breathing and lung development. VEPTR straightens the spine and opens a larger space for your child's lungs and other internal organs to grow by placing a titanium device between two ribs to push them apart. In an outpatient surgical procedure, VEPTR can be expanded every four to six months as your child grows.
- We use growing rods in a similar fashion to VEPTR. We attach the rods to the spine and affix them to vertebrae at the top and the bottom. In a simple outpatient surgery, we lengthen them periodically. Growing rods minimize spinal deformity, allow spine growth, and — most importantly — allow lung development to occur to preserve a normal life span for your child.
- We are one of only a few hospitals in the country to offer spinal stapling, a novel treatment alternative for children who have progressive scoliosis at a young age. Spinal stapling controls growth, allowing correction of spinal curves without fusion and without multiple procedures. Stapling not only stops scoliosis from getting worse, but can even correct the curve.
- Spinal stapling is a two-hour minimally invasive surgery that involves implanting inch-long metallic staples across the growth plates of the spine, guided by a camera called a thoracoscope. We complete the procedure through a small incision. Spinal stapling is available for children with progressive moderate scoliosis (less than 30 degrees) who are still growing (girls up to age 14 and boys up to age 16).
- For children with larger curves, we sometimes combine spinal stapling with growing rods or VEPTR. We are using this new hybrid technique in children with curves greater than 35 degrees, and we're seeing very good results.
- Children return to active, vibrant lives just months after surgery. We make adjustments every six to nine months as they grow, typically on an outpatient basis.
MAGEC® Remotely Controlled Growing Rods
- In 2014, we became the first hospital in New York City to offer MAGEC growing rods. MAGEC treatment involves the surgical placement of special growing rods in your child's spine, which we adjust every few months afterward using a remote-controlled device applied to the outside of your child's back during a routine outpatient visit.
- Both the rods and the controller contain magnets. Applying the controller to your child's back, we lengthen the rods with extraordinary precision. This technique spares your child from the need for repeated surgeries.