TY - JOUR
T1 - An initial effort to define an early onset scoliosis “graduate”—The Pediatric Spine Study Group experience
AU - The Pediatric Spine Study Group
AU - Hardesty, Christina K.
AU - Murphy, Robert F.
AU - Pawelek, Jeff B.
AU - Glotzbecker, Michael P.
AU - Hosseini, Pooria
AU - Johnston, Charles E.
AU - Emans, John
AU - Akbarnia, Behrooz A.
N1 - Publisher Copyright:
© 2020, Scoliosis Research Society.
PY - 2021/5
Y1 - 2021/5
N2 - Purpose: Increasingly, patients with early onset scoliosis (EOS) are completing a growth friendly surgical program followed by observation, removal of implants or a definitive spinal fusion. These patients are colloquially referred to as “graduates”. A standardized definition of a graduate is needed for research and comparing the outcomes, family counseling, and a better understanding of the population. Methods: A 15-question electronic survey was completed by 39 experienced pediatric spine surgeons to identify factors salient to the definition of a graduate of EOS surgical programs. A Delphi/Nominal group technique session with nine questions was then performed face-to-face with 21 members of the Pediatric Spine Study Group to discuss and refine the definition. A follow-up electronic survey was then distributed to these same 21 members to gain consensus on the final definition. Results: From the initial survey, it was identified that a graduate did not require definitive spinal fusion after a growing program. From the Delphi session, it was determined that skeletal maturity was the most important factor in defining a graduate. A strictly defined minimum length of follow-up was not felt to be a prerequisite for qualification of graduation. After the final electronic version was distributed, > 80% of respondents agreed upon the final definition, thereby achieving consensus. Conclusion: The Pediatric Spine Study Group recommends adoption of the following definition: a “graduate” is a patient who has undergone any surgical program to treat early onset scoliosis, and has reached skeletal maturity and does not have a planned surgical intervention for EOS in the future. Level of evidence: V.
AB - Purpose: Increasingly, patients with early onset scoliosis (EOS) are completing a growth friendly surgical program followed by observation, removal of implants or a definitive spinal fusion. These patients are colloquially referred to as “graduates”. A standardized definition of a graduate is needed for research and comparing the outcomes, family counseling, and a better understanding of the population. Methods: A 15-question electronic survey was completed by 39 experienced pediatric spine surgeons to identify factors salient to the definition of a graduate of EOS surgical programs. A Delphi/Nominal group technique session with nine questions was then performed face-to-face with 21 members of the Pediatric Spine Study Group to discuss and refine the definition. A follow-up electronic survey was then distributed to these same 21 members to gain consensus on the final definition. Results: From the initial survey, it was identified that a graduate did not require definitive spinal fusion after a growing program. From the Delphi session, it was determined that skeletal maturity was the most important factor in defining a graduate. A strictly defined minimum length of follow-up was not felt to be a prerequisite for qualification of graduation. After the final electronic version was distributed, > 80% of respondents agreed upon the final definition, thereby achieving consensus. Conclusion: The Pediatric Spine Study Group recommends adoption of the following definition: a “graduate” is a patient who has undergone any surgical program to treat early onset scoliosis, and has reached skeletal maturity and does not have a planned surgical intervention for EOS in the future. Level of evidence: V.
KW - Early-onset scoliosis
KW - Graduate
KW - Scoliosis
KW - Spinal deformity
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U2 - 10.1007/s43390-020-00255-6
DO - 10.1007/s43390-020-00255-6
M3 - Review article
C2 - 33258069
AN - SCOPUS:85096914371
SN - 2212-134X
VL - 9
SP - 679
EP - 683
JO - Spine deformity
JF - Spine deformity
IS - 3
ER -