<div class="page" title="Page 149"><div class="layoutArea"><div class="column"><p><span style="font-size: 10pt; font-family: TimesNewRomanPSMT;">Early-onset scoliosis (EOS) is the complex deformity of the spine that occurs in children under ten years of age and an abnormal curvature of the spine greater than ten degrees. One of the treatment options for early- onset scoliosis is early spinal fusion. In EOS with severe spinal scoliosis or kyphosis, multilevel posterior spinal fusion (PSF) is not the standard surgical treatment. Nevertheless, fusion may be considered and severe cases, such as congenital deformities or syndromic entities based on the prognosis of the disease. EOS produces restrictive lung disease by constraining and deforming the intrathoracic space, increasing the rigidity of the chest wall, and impairing respiratory muscle function. Children who have undergone spinal fusion may experience reduced lung function due to the decreased ability of the chest wall to expand during breathing. Spinal fusion involves fusing the vertebrae together, which reduces the flexibility of the spine. This can severely limit the ability of the child to grow taller as the spine cannot elongate anymore. This is particularly problematic for younger children who have not yet reached their full potential in height. Children who undergo spinal fusion may require additional surgeries to correct for complications that arise from the initial procedure.</span></p></div></div></div>