1 Recommendations

Guidance

1.1 Minimally invasive fusionless posterior-approach surgery to correct idiopathic scoliosis in children and young people should be used only in research. Find out what only in research means on the NICE interventional procedures guidance page.

1.2 Further research should include:

patient selection in terms of age, skeletal maturity, and site and degree of scoliosis
the technique and device (including version) used
patient-reported outcomes
potential damage from local inflammatory processes (including metallosis) and systemic metal poisoning
long-term movement in the thoracic spine
long-term complications for the lifetime of the device.

Why the committee made these recommendations

The evidence on efficacy and safety for the procedure is limited. There are only a few studies, which are small and provide no long-term data.

The procedure aims to preserve movement in the spine but there is no evidence about whether this is beneficial. Also, different versions of the device have been used in different studies, and there is limited evidence for the current version.

There are also safety concerns about:

potential build-up of metal in the body (metallosis) and metal poisoning from titanium in the device
bone destruction (osteolysis) where the device is attached to the spine.

This procedure is only recommended for use in research because, overall, there is not enough good quality evidence on its safety and efficacy.