Classification of Early Onset Scoliosis has Excellent Interobserver and Intraobserver Reliability

Cyr, Micaela; Hilaire, Tricia St.; Pan, Zhaoxing; Thompson, George H.; Vitale, Michael G.; Garg, Sumeet

doi:10.1097/bpo.0000000000000688

Cited by 27 publications

(6 citation statements)

References 8 publications

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“…Nonetheless, all patients were classified using the original paper by Williams et al by a fellowship-trained Pediatric Spinal Surgeon and audited 3 months after the initial classification by the authors and found to be correct 1 . This is in keeping with previous findings from Cyr et al who reported excellent interobserver and intraobserver reliability for the C-EOS classification 29 …”

Section: Discussionsupporting

confidence: 69%

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Weight Gain and Nutritional Improvement After Magnetically Controlled Growing Rod Surgery in Early-Onset Scoliosis: A Single Centre Analysis of 68 Patients

Turner

Hayes

McManus

et al. 2023

Journal of Pediatric Orthopaedics

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Background: Early-onset scoliosis (EOS) is frequently associated with complex spine and chest wall deformities that may lead to severe cardiopulmonary impairment and malnutrition. The aim of this study is to evaluate the change in the nutritional status of EOS patients after treatment with magnetically controlled growing rod instrumentation (MCGR) in a single center. Methods: We prospectively collected data of patients treated with MCGR for EOS in a single center. Exclusion criteria were <2 years’ follow-up and incomplete weight-for-age Z-scores (WAZ) data. Preoperative and postoperative WAZ, radiographic parameters, including major coronal curve, kyphosis angle, space available for lung ratios, thoracic height, and unplanned returns to the operating room (UPROR), were analyzed. SD and 95% Confidence intervals (CI) are presented with means. Results: Sixty-eight patients (37 males/31 females) were included. The mean age at surgery was 8.2 years (SD 2.8, range 1.8–14.2), and the mean follow-up time was 3.8 years (SD 1.0, range 2.1–6.8). The study population was categorized by the primary diagnosis as follows: 23 neuromuscular, 18 idiopathic, 15 congenital, and 12 syndromic patients. The major coronal curve improved between the preoperative and latest visits by 40% (P<0.005, SD 27, CI 33–47), while the space available for lung ratios improved by 8% (P<0.005, SD 13, CI 5–12). Thoracic height increased by 25% (P<0.005, SD 13, CI 22–28), and kyphosis angle decreased by 25% (P<0.005, SD 26, CI 9–39). Eighteen patients (27%) required a total of 53 UPRORs. WAZ improved significantly between the preoperative and the latest follow-up (P=0.005). Regression analysis showed WAZ improvements were most significant in the underweight patients and the Idiopathic or Syndromic EOS patients. UPROR was not associated with deterioration in WAZ. Conclusions: Treatment of EOS patients with MCGR resulted in an improvement in nutritional status, as evidenced by the significant increase in WAZ. Underweight, Idiopathic and Syndromic EOS patients, and those who required UPROR all had significant improvement in their WAZ with MCGR treatment. Level of Evidence: Therapeutic Study—Level II.

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Section: Discussionsupporting

confidence: 69%

“…1 This is in keeping with previous findings from Cyr et al who reported excellent interobserver and intraobserver reliability for the C-EOS classification. 29…”

Section: Discussionmentioning

confidence: 99%

Weight Gain and Nutritional Improvement After Magnetically Controlled Growing Rod Surgery in Early-Onset Scoliosis: A Single Centre Analysis of 68 Patients

Turner

Hayes

McManus

et al. 2023

Journal of Pediatric Orthopaedics

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“…The standardized method contains a continuous classification prefix for age, three core variables (etiology, major curve, and kyphosis), and an optional modifier for curve progression (6). This classification system was based on the expertise of 15 experienced surgeons demonstrating a high level of agreement, consistency, and reliability in clinical and academic settings (16). However, the classification system has not yet been widely used in EOS literature, considering that it is relatively new.…”

Section: Classificationmentioning

confidence: 99%

Early-onset scoliosis: a narrative review

et al. 2022

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Early-onset scoliosis (EOS) is defined as any spinal deformity that is present before 10 years old, regardless of etiology. Deformity must be evaluated based on the intercorrelation between the lungs, spine, and thorax. Curvatures of early-onset have increased risk of progression, cardiorespiratory problems, and increased morbidity and mortality. Progression of the deformity may produce thoracic insufficiency syndrome, where a distorted thorax is unable to support normal respiratory function or lung growth. Management and treatment of EOS should pursue a holistic approach in which the psychological impact and quality of life of the patient are also taken into consideration. Growth-friendly surgical techniques have not met the initial expectations of correcting scoliotic deformity, promoting thoracic growth, and improving pulmonary function.

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“…Classification systems can be useful tools for clinical care and research but must be proven as reliable. The C-EOS scheme can be used as a tool for classifying EOS patients for clinical communication and research [12] . Fig.…”

Section: Classificationmentioning

confidence: 99%

Review Article: Early Onset Scoliosis: Definition, Etiology, Physical Examinations, Classification, and Methods of Treatment

EL-SADEK¹,

EL-SABROUT²

2018

The Medical Journal of Cairo University

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Background: Early Onset Scoliosis (EOS) is defined as scoliosis occurring before the age of 5 years. It affects not only the growing spine but also has a direct influence on the cardiopulmonary development and function of the child. Cardiopulmonary function is compromised as a result of decreased size of the thoracic cavity, which has a negative effect on lung alveolar development. The goal in the management of EOS is to control the deformity and allow continued growth of the spine and thoracic cavity. Non-fusion instrumentation facilitates this and allows ongoing respiratory development and optimal cardiopulmonary functions. However some authors describe that early onset scoliosis is that scoliosis starts before the age of 10 years. The debate in these definitions is made because of the difference in spine growth and cardiopulmonary compromise before and after age of five.

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Classification of Early Onset Scoliosis has Excellent Interobserver and Intraobserver Reliability

Abstract: Level II-diagnostic study.

Cited by 27 publications

References 8 publications

Weight Gain and Nutritional Improvement After Magnetically Controlled Growing Rod Surgery in Early-Onset Scoliosis: A Single Centre Analysis of 68 Patients

Weight Gain and Nutritional Improvement After Magnetically Controlled Growing Rod Surgery in Early-Onset Scoliosis: A Single Centre Analysis of 68 Patients

Early-onset scoliosis: a narrative review

Review Article: Early Onset Scoliosis: Definition, Etiology, Physical Examinations, Classification, and Methods of Treatment

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