Scoliosis in children can be present at birth or it can develop in adolescence. This blog will discuss the hallmarks of scoliosis in children as well as types of treatment that can be indicated for young people with scoliosis.
Scoliosis is a three-dimensional deformity affecting all three planes of the body. That makes it difficult to visualize with two-dimensional radiographs. An orthopedic specialist who specializes in spinal deformities can help make a diagnosis.
Congenital diseases are those that are present at birth. Congenital scoliosis results from malformation of the spinal segments. It may be indicated by abnormal development of the spine resulting in:
- A missing portion
- Partial formation
- Lack of separation of the vertebrae
In cases where there is failure of formation in the spine, two different conditions may be present:
- Partial unilateral failure of formation, or wedge vertebrae
- Complete unilateral failure of formation, or hemivertebrae
In cases where there is failure of segmentation in the spine two different conditions may be present:
- Unilateral failure of segmentation, or congenital bar
- Bilateral failure of segmentation, or block vertebrae
The risk of scoliosis progression depends on the degree of curve. A less than 30-degree curve has a risk progression of 50 percent. A 5- to 30-degree curve has a risk progression of 25 percent. Twenty-five percent of cases are non-progressive.
Idiopathic scoliosis arises later in childhood. This type of scoliosis in children can be classified as:
- Infantile: Affecting those under three years of age
- Juvenile: Affecting those ages three to ten
- Adolescent: Affecting children older than ten
Idiopathic scoliosis cases among infants affect boys more than girls. A large swath — 80 percent — of cases resolve without treatment.
Juvenile cases of scoliosis are equally divided between boys and girls. Adolescents with scoliosis, however, are 80 percent girls.
Adolescent Idiopathic Scoliosis
Most patients with adolescent idiopathic scoliosis have small curves. The greater the degree of the curve, the more likely the condition is to progress. The frequency and prognosis (within the general population) is:
- 5 percent have a curve of 10 degrees or less
- 0.5 percent have a curve of 20 degrees or less
- 0.2 percent have a curve of 30 degrees or less
- 0.1 percent have a curve of 40 degrees of less
Treatment options for the types of scoliosis affecting adolescents ranges from observation to surgery. Curves that are less than 25 degrees will likely be put under observation by an orthopedic specialist, with follow-up radiographs at regular intervals.
Bracing will be a likely course of treatment for patients with:
- Curves that range from 25 to 40 degrees with flexibility
- Curves from 40 to 50 degrees
- Smaller curves from 20 to 25 degrees that demonstrate rapid progression
Spinal surgery may be considered when patients have inflexible curves that exceed 40 degrees or have a curve that exceeds 50 degrees.
Neuromuscular scoliosis — which can also affect children — arises from neurologic or muscular diseases, such as cerebral palsy, muscular dystrophy or polio.
If you're concerned that your child may have scoliosis or another spine disorder, talk to an orthopedic specialist.