Early onset scoliosis: Can Best Practice Guidelines Be Provided in Europe?

IF 1.8 4区 医学 Q3 ORTHOPEDICS
Journal of Childrens Orthopaedics Pub Date : 2025-11-29 eCollection Date: 2026-02-01 DOI:10.1177/18632521251398742
Brice Ilharreborde, Muharrem Yazici, Selcen Yüksel, Pervin Demir, Ilkka Helenius
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引用次数: 0

Abstract

Background: The goal of treatment in early onset scoliosis patients is to control the deformity while allowing chest and spinal growth. However, management, either conservative or surgical, remains controversial and require further clinical evidence. The aim of this study was to determine best practice guidelines for the management of early onset scoliosis patients in Europe.

Methods: A Delphi approach was used among European experts to determine consensus in: (1) identification of progression risk factors, (2) clinical and radiographic evaluation, (3) conservative treatment, and (4) surgical management. Idiopathic and non-idiopathic groups were analyzed separately. Statements were only included in the final agreed consensus if at least 80% of respondents agreed with the statement.

Results: A total of 22 pediatric orthopedic surgeons completed the first and second surveys, and 21 the third. Out of open-ended questions included in the initial Delphi, 75 statements for 59 multiple-choice questions in the idiopathic group and 47 statements for the 44 multiple-choice questions for the non-idiopathic group were formed for the second round. Of the total 122 statements, 50 (40.9%) reached consensus, and 72 did not. Among the 72 statements re-evaluated in Round 3, consensus was reached on 69 (96%).

Conclusion: Early onset scoliosis represents a rare, heterogeneous, but life-threatening condition often associated with insufficient relevant evidence. Consensus is difficult to achieve (39.3% of the 122 statements), especially in the non-idiopathic group. However, 48 guidelines (33 for idiopathic and 15 for non-idiopathic) were provided by European experts to improve early onset scoliosis management.

Level of evidence: IV.

早发性脊柱侧凸:欧洲可以提供最佳实践指南吗?
背景:早期脊柱侧凸患者的治疗目标是控制畸形,同时允许胸部和脊柱生长。然而,无论是保守治疗还是手术治疗,仍然存在争议,需要进一步的临床证据。本研究的目的是确定欧洲早发性脊柱侧凸患者管理的最佳实践指南。方法:采用德尔菲法在欧洲专家中确定共识:(1)识别进展危险因素,(2)临床和影像学评估,(3)保守治疗,(4)手术处理。特发性组和非特发性组分别进行分析。只有在至少80%的受访者同意该陈述的情况下,该陈述才被纳入最终商定的共识。结果:共22名儿科骨科医生完成了第一次和第二次调查,21名完成了第三次调查。在最初德尔菲的开放式问题中,特发性组的59个多项选择题的75个陈述和非特发性组的44个多项选择题的47个陈述形成了第二轮。在122份声明中,达成共识的有50份(40.9%),未达成共识的有72份。在第三轮重新评估的72项声明中,有69项(96%)达成了共识。结论:早发性脊柱侧凸是一种罕见的、异质性的、但危及生命的疾病,通常相关证据不足。很难达成共识(122个陈述中有39.3%),特别是在非特发性组。然而,欧洲专家提供了48项指南(33项针对特发性,15项针对非特发性),以改善早发性脊柱侧凸的管理。证据等级:四级。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Childrens Orthopaedics
Journal of Childrens Orthopaedics Medicine-Orthopedics and Sports Medicine
CiteScore
2.70
自引率
14.30%
发文量
61
审稿时长
23 weeks
期刊介绍: Aims & Scope The Journal of Children’s Orthopaedics is the official journal of the European Paediatric Orthopaedic Society (EPOS) and is published by The British Editorial Society of Bone & Joint Surgery. It provides a forum for the advancement of the knowledge and education in paediatric orthopaedics and traumatology across geographical borders. It advocates an increased worldwide involvement in preventing and treating musculoskeletal diseases in children and adolescents. The journal publishes high quality, peer-reviewed articles that focus on clinical practice, diagnosis and treatment of disorders unique to paediatric orthopaedics, as well as on basic and applied research. It aims to help physicians stay abreast of the latest and ever-changing developments in the field of paediatric orthopaedics and traumatology. The journal welcomes original contributions submitted exclusively for review to the journal. This continuously published online journal is fully open access and will publish one print issue each year to coincide with the EPOS Annual Congress, featuring the meeting’s abstracts.
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