Novel invasive surgery for children with scoliosis may eliminate need for spinal fusion

A novel minimally invasive surgery for young children living with a difficult-to-treat progressive form of scoliosis, known as juvenile idiopathic scoliosis, may eliminate the need for spinal fusion later in adolescence, according to new research by surgeons from Children's Mercy Hospitals and Clinics in Kansas City, Mo. The study was presented at the American Academy of Pediatrics National Conference and Exhibition in San Francisco.

The procedure, known as vertebral body stapling, is a minimally invasive technique during which a series of metal connectors are placed to slow growth on one side of the spine. In the study, seven children (ages 8-11) were followed for an average of 18 months after the procedure, and showed no sign of further progression or the need for additional bracing or surgery.

Juvenile idiopathic scoliosis differs from other forms of scoliosis, a curving deformity of the spine, because it develops during a period in which the spine does not undergo significant growth. The condition almost always worsens over time, and represents up to 20 percent of scoliosis cases. It can also lead to heart and lung complications if not properly treated.

Juvenile idiopathic scoliosis often progresses despite external body bracing, so these patients may require a series of operations to prevent further curvature. Surgical procedures, including spinal fusions, vertebrae resections and growing rods have been explored in stopping abnormal spinal growth. However, each procedure has its limitations and is followed by a long and difficult rehabilitation process.

"Scoliosis can be a challenge to treat, and can cause significant emotional distress to the child who must wear a body brace or be subjected to multiple surgeries," said George W. Holcomb III, MD, MBA, surgeon-in-chief at Children's Mercy. "Our study demonstrates this relatively straight-forward procedure may be the answer for especially serious cases in young children with significant scoliosis."

To further their research, surgeons at Children's Mercy are conducting continuous patient follow up to determine the long term success of vertebral body stapling throughout adulthood.