Reproducibility of the classification of early onset scoliosis (C-EOS)

Dragsted, Casper; Ohrt-Nissen, Søren; Hallager, Dennis Winge; Tøndevold, Niklas; Andersen, Troels; Dahl, Benny; Gehrchen, Martin

doi:10.1007/s43390-019-00006-2

Cited by 5 publications

(5 citation statements)

References 25 publications

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“…In 2020, Dragsted et al found that the designed classification system had a substantial agreement for etiology. The reliability for major curve angle was excellent but somewhat lower and accurate for kyphosis and annual curve progression (17). They suggest a revision to the annual curve progression since its limit of agreement was larger than the 10° per year increments initially proposed by the classification (17).…”

Section: Classificationmentioning

confidence: 92%

“…The reliability for major curve angle was excellent but somewhat lower and accurate for kyphosis and annual curve progression (17). They suggest a revision to the annual curve progression since its limit of agreement was larger than the 10° per year increments initially proposed by the classification (17). As new studies surge, further modifications could be expected to the classification, increasing its validation, reliability, and acceptance in literature to allow orthopedists to guide their EOS management.…”

Section: Classificationmentioning

confidence: 96%

“…However, the classification system has not yet been widely used in EOS literature, considering that it is relatively new. To some extent, its variables and cutoffs are based on expert opinion; therefore, it still requires further studies to validate its content (17). In 2020, Dragsted et al found that the designed classification system had a substantial agreement for etiology.…”

Section: Classificationmentioning

confidence: 99%

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Early-onset scoliosis: a narrative review

et al. 2022

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Early-onset scoliosis (EOS) is defined as any spinal deformity that is present before 10 years old, regardless of etiology. Deformity must be evaluated based on the intercorrelation between the lungs, spine, and thorax. Curvatures of early-onset have increased risk of progression, cardiorespiratory problems, and increased morbidity and mortality. Progression of the deformity may produce thoracic insufficiency syndrome, where a distorted thorax is unable to support normal respiratory function or lung growth. Management and treatment of EOS should pursue a holistic approach in which the psychological impact and quality of life of the patient are also taken into consideration. Growth-friendly surgical techniques have not met the initial expectations of correcting scoliotic deformity, promoting thoracic growth, and improving pulmonary function.

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Section: Classificationmentioning

confidence: 92%

Section: Classificationmentioning

confidence: 96%

Section: Classificationmentioning

confidence: 99%

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Early-onset scoliosis: a narrative review

et al. 2022

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“…Validation of the C-EOS showed substantial to excellent interobserver and intraobserver reliability. 3 The natural history varies with the underlying disease and may be associated with increased mortality. 4,5 At the same time, the principle of early definitive spinal fusion, which was still practiced until the beginning of the new millennium, has taught us not only revision rates of up to 39% but also the disastrous influence of a short (thoracic) spine on pulmonary function.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic and therapeutic strategies in early onset scoliosis: A current concept review

Studer,

Hasler

2024

Journal of Children's Orthopaedics

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Substantial advances in the treatment of early onset scoliosis (EOS) over the past two to three decades have resulted in significant improvements in health-related quality of life of affected children. In addition to classifications that address the marked heterogeneity of this patient population, increasing understanding of the natural history of the disease, and new implants and treatment techniques have resulted in innovations unlike any other area of pediatric orthopedics. The growing understanding of the interaction between spinal and thoracic growth, as well as dependent lung maturation, has had a lasting impact on the treatment strategy of this potentially life-threatening disease. The previous treatment approach with early corrective fusion gave way to a growth-friendly concept. Despite the steady development of new growth-friendly surgical treatment options, whose efficacy still needs to be validated, as well as a revival of conservative growth control with serial casts and/or braces, the psychosocial burden of the long lasting and complication-prone treatments remains high. As a consequence, EOS still represents one of the greatest pediatric orthopedic challenges.

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“…C-EOS is the only available classification system to group EOS patients based on the pre-operative clinical indices. While the system is both reliable and accurate, the cut-offs for major curve (Cobb) angle and kyphosis are not based on a data-driven approach [ 9 ]. In addition, the 48 subgroups in C-EOS limit meaningful analysis due to a small number of patients in each subgroup, thereby making it difficult to correlate interventions with outcomes [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Automated Clustering Technique (ACT) for Early Onset Scoliosis: A preliminary report

et al. 2023

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Purpose While the C-EOS system helps organize and classify Early Onset Scoliosis (EOS) pathology, it is not data-driven and does not help achieve consensus for surgical treatment. The current study aims to create an automated method to cluster EOS patients based on pre-operative clinical indices. Methods A total of 1114 EOS patients were used for the study, with the following distribution by etiology: congenital (240), idiopathic (217), neuromuscular (417), syndromic (240). Pre-operative clinical indices used for clustering were age, major curve (Cobb) angle, kyphosis, number of levels involved in a major curve (Cobb angle) and kyphosis along with deformity index (defined as the ratio of major Cobb angle and kyphosis). Fuzzy C-means clustering was performed for each etiology individually, with one-way ANOVA performed to assess statistical significance (p < 0.05). Results The automated clustering method resulted in three clusters per etiology as the optimal number based on the highest average membership values. Statistical analyses showed that the clusters were significantly different for all the clinical indices within and between etiologies. Link to the ACT-EOS web application: https://biomed.drexel.edu/labs/obl/toolkits/act-eos-application. Conclusion An automated method to cluster EOS patients based on pre-operative clinical indices was developed identifying three unique, data-driven subgroups for each C-EOS etiology category. Adoption of such an automated clustering framework can help improve the standardization of clinical decision-making for EOS.

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Reproducibility of the classification of early onset scoliosis (C-EOS)

Cited by 5 publications

References 25 publications

Early-onset scoliosis: a narrative review

Early-onset scoliosis: a narrative review

Diagnostic and therapeutic strategies in early onset scoliosis: A current concept review

Automated Clustering Technique (ACT) for Early Onset Scoliosis: A preliminary report

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