Autofusion in surgery for early onset scoliosis: literature review and analysis of own data

The literature review considers the pathophysiology of autofusion, its frequency, and the consequences of the spontaneous bone block development in growing children, as well as the necessity of final fusion using segmental instrumentation and bone grafting in surgeryfor early onset scoliosis. The article presents the authors’ own material on the surgical treatment of 131 patients with early onset scoliosis of various etiologies using VEPTR instrumentation, of which 84 patients completed the cycle of multi-stage treatment. During stagedistractions and final fusion, the presence of spontaneous bone blocks of various localizations was ascertained. At the points of distraction rod fixation, the signs of autofusion were noted in 100 % of cases. There was not a single case of posterior vertebral autofusion along the apical and periapical zones of the main curve. In 21 patients, 22 complications were detected that required repeated intervention after the final fusion. The presented experience shows that the final stage of surgical treatment of patients with early onset scoliosis should include removal of VEPTR rods, correction of the deformity with segmental instrumentation and spinal fusion with local autobone along the entire length of the curvature.