Interventional procedure overview of minimally invasive fusionless posterior-approach surgery to correct idiopathic scoliosis in children and young people

Indications and current treatment

Scoliosis is a complex 3-dimensional change to the spine in the coronal, sagittal, and axial planes. It causes the bones of the spine to twist or rotate so that the spine curves sideways. Scoliosis curves most commonly occur in the thoracic spine but can also occur in the lumbar spine. Occasionally, they occur in both the thoracic and lumbar spine.

Adolescent idiopathic scoliosis (AIS) is the most common type of scoliosis in children and young people. It is progressive and its exact cause is unknown. Mild to moderate spinal curvature does not cause any health problems but can cause cosmetic concerns. Severe spinal curvature with secondary rib changes can also cause significant pain and lung problems.

Treatment of AIS depends on several factors, including skeletal maturity, location of the spinal curve, speed of curve progression and size of the curve. Conservative treatments for mild to moderate AIS include routine surveillance (spinal imaging to monitor progression) and physical therapy. For severe AIS, interventions include casting or bracing (for curves of more than 25 degrees), or spinal fusion surgery (for curves of more than 40 degrees) with various instrumented metallic fixation techniques and grafting to fuse vertebrae. Minimally invasive growth modulating and fusionless surgical techniques to correct idiopathic scoliosis include vertebral body stapling, vertebral body tethering, magnetically controlled growing rods and sublaminar polyester bands. These are also being used for AIS in some people. The aim is to correct the scoliosis, prevent progression, restore balance, and reduce pain and morbidity.