Preoperative optimization and nutrition
Due to the complexity and frequency of comorbidities associated with early onset scoliosis, preoperative optimization is mandatory to prepare patients and families for casting and/or surgical intervention. Multidisciplinary collaboration across several specialties is often required. Preoperative optimization strategies should focus on identifying and managing comorbid organ systems that may affect the outcome of spinal surgery. Frequent examples include nutritional supplementation for wound healing potential and soft tissue envelope coverage for implants, pulmonary evaluation for thoracic insufficiency, and gastrointestinal and genitourinary toilet for prevention of ileus and urinary tract infections. Other considerations include cardiac and renal evaluation in congenital scoliosis patients.
