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Classification of Early-Onset Scoliosis

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The Growing Spine

Abstract

Early-onset scoliosis (EOS) is a complex and heterogeneous condition of significant diversity with respect to etiology, natural history, and management. Until recently, the lack of an organizing structure to condense the varied manifestations of EOS has slowed efforts to conduct the higher level of evidence studies necessary to establish best practices. That is, without a classification to reliably stratify children with EOS, it has been difficult to draw meaningful comparisons of outcomes before and after treatment. In light of this need, the Classification of Early-Onset Scoliosis (C-EOS) was developed to provide a comprehensive, practical, and predictive novel classification system designed exclusively for young patients with scoliosis.

To identify those factors which are most important in managing EOS, 15 experienced surgeons participated in a nominal group technique. Consisting of three in-person meetings, two rounds of surveying, and a case-based interobserver reliability assessment, the group determined consensus-based classification components, subgroupings, and cut-points.

The C-EOS consists of a continuous age prefix, etiology (congenital or structural, neuromuscular, syndromic, and idiopathic), major curve angle (1, 2, 3, or 4), kyphosis (−, N, or +), and an optional progression modifier (P0, P1, or P2). Studies examining the intraobserver reliability, clinical reliability, and validity are underway. It is hoped that by providing a common language and scaffold around which to guide ongoing research, the C-EOS will ultimately lead to improved outcomes for children with early-onset scoliosis.

Substantial portions of this research were previously published in Vitale MG. Development and initial validation of a novel classification system for early-onset scoliosis: Classification of Early-Onset Scoliosis (C-EOS). JBJS 2014;96(16): 1359–1367. With permission from Rockwater, Inc.

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Author information

Authors and Affiliations

  1. Division of Pediatric Orthopaedics, Department of Orthopaedic Surgery, Columbia University Medical Center, New York, NY, USA

    Michael G. Vitale MD, MPH

  2. Department of Pediatric Orthopaedic Surgery, Morgan Stanley Children’s Hospital of New York Presbyterian, 3959 Broadway, 8 North, New York, NY, 11223, USA

    Michael G. Vitale MD, MPH

  3. Department of Orthopaedic Surgery, Columbia University Medical Center, New York, NY, USA

    Evan Trupia BS

Authors
  1. Michael G. Vitale MD, MPH
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  2. Evan Trupia BS
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Correspondence to Michael G. Vitale MD, MPH .

Editor information

Editors and Affiliations

  1. San Diego Center for Spinal Disorders Medical Group, Inc., La Jolla, California, USA

    Behrooz A. Akbarnia

  2. Hacettepe University Dept. Orthopedics & Traumatology, Sihhiye, Ankara, Turkey

    Muharrem Yazici

  3. Rainbow Babies & Children's Hospital, Cleveland, Ohio, USA

    George H. Thompson

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Vitale, M.G., Trupia, E. (2016). Classification of Early-Onset Scoliosis. In: Akbarnia, B., Yazici, M., Thompson, G. (eds) The Growing Spine. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-48284-1_7

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  • DOI: https://doi.org/10.1007/978-3-662-48284-1_7

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-48283-4

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