Early onset scoliosis
Early-onset scoliosis is the abnormal lateral curvature of spine that occurs in children who are less than 5 years. There is no known cause for a young child to have developed scoliosis at this age.This condition includes children with congenital scoliosis (present at birth) and infantile scoliosis (birth to 3 years). Early onset scoliosis is associated with congenital chest deformities, neuromuscular disorders such as cerebral palsy, muscular disease, and tumor. Early-onset scoliosis generally affects boys more often than girls.
Early onset scoliosis does not cause any pain but it may affect your child’s overall appearance.
Your doctor identifies the condition by performing ‘Adam’s forward bend test’. During this test your child is asked to bend forward andyour doctor looks for the symmetry of the hips and shoulders, and the curve of the spine from the sides, front and the back. X-ray of the spine is taken to measure the degree of severity of curvature. An MRI scan of the entire spine is often recommended to detect any neurologic changes.
Treatment of scoliosis is based on the physician’s assessment of the spinal curve, its cause, the age of the child, and the expected growth of the child. Treatment options include non-surgical and surgical treatment. Non-surgical treatment consists of observation, bracing, and casting.
- Observation: The child is examined every 3 to 4 months to monitor the curve. After the observation if your child’s curve is progressing then additional treatments may be required.
- Bracing: Your doctor may recommend wearing a brace to prevent worsening of the curve. Braces do not treat the condition but it helps to slow the progression of the curve. However bracing is not effective in neuromuscular scoliosis and congenital scoliosis.
- Casting: Cast is applied to your child’s trunk which controls and corrects the curve by allowing the spine to grow in a normal manner. The cast is changed regularly until the curvature is reduced.
If the conservative treatments do not control the curving, your doctor may suggest surgery. Children’s who are at a risk of developing respiratory and cardiac problems because of progression of curve may be recommended for surgery. Surgical modality includes insertion of implants such as growth rods, vertical expandable prosthetic titanium rib prostheses (VEPTR), and spinal staples. These implants help in correcting the curvature without interfering with the growth of the spine.
Growth rods are expandable devices that are attached to the top and base of the spine with the help of internal fixators such as screws and hooks.
Vertical expandable prosthetic titanium rib prostheses are artificial devices that are placed between your child’s ribs to move them apart. It straightens the spine and increases the space for lungs and improves pulmonary function.
Spinal stapling is a minimally invasive technique that involves implanting metallic staples across the growth plate of the spine. This procedure modulates growth and corrects the curve without spinal fusion procedure.