Complications with early onset scoliosis

The surgical management of early onset scoliosis is fraught with a number of complications. In addition to medical complications associated with a heterogeneous group of underlying diagnoses, the potential for surgical complications is high given the paucity of spine/rib anchors and the competing effort to control deformity while allowing spinal growth. While the literature does not offer high level of evidence guidance on how to avoid complications related to implants, certain principles dictate that one should treat the entirety of the spinal deformity with a construct which is long enough to do so, utilizing dual-rod techniques for most deformities and whenever feasible, utilizing sufficient anchors to avoid early bone-implant failure. Risk factors for implant failure such as kyphosis and non-idiopathic diagnoses must be recognized.