Surgical Interventions for Pediatric Scoliosis: A Systematic Review of Neurological Risks and Functional Benefits

Introduction: Pediatric scoliosis requiring surgery presents complex challenges, with treatment aimed at preventing progression and improving function while minimizing risks. Neurological complications and functional benefits are central to evaluating surgical outcomes. Objective: The main objective was to assess neurological risks and functional benefits associated with surgical interventions for pediatric scoliosis. Secondary objectives included comparing outcomes across surgical techniques, evaluating long-term quality of life, and identifying predictors of complications. Methods: Systematic searches were performed in PubMed, Scopus, Web of Science, Cochrane Library, LILACS, ClinicalTrials.gov, and ICTRP. Eligible studies were published within the last 5 years, expanded to 10 if fewer than 10 relevant studies were found. Risk of bias was assessed with RoB 2, ROBINS-I, and QUADAS-2, with certainty of evidence graded using GRADE. Results and Discussion: A total of 1,046 records were identified, with 28 studies included after screening. Neurological complication rates ranged from 1% to 7%, with intraoperative monitoring shown to reduce risks. Functional benefits included improvements in pulmonary function, pain reduction, and quality of life. Variability in outcomes was associated with etiology, curve severity, and surgical technique. Conclusion: Surgical intervention in pediatric scoliosis is generally safe and provides significant functional benefits, though residual risks remain. Multidisciplinary care, careful patient selection, and standardized follow-up protocols are essential to optimize outcomes. Descriptors: Scoliosis, Pediatrics, Neurosurgical Procedures, Quality of Life