Pediatric Early Onset Scoliosis

Neuromuscular

Neuromuscular — Some children with early onset scoliosis also have a disease that affects their nerves and muscles, such as cerebral palsy or spina bifida.

Syndromic

Syndromic — Some children with early onset scoliosis also have a disorder affecting their bones or development, such as bone dysplasia or Prader-Willi syndrome.

Idiopathic

Idiopathic — Sometimes we can’t explain why a child has scoliosis. (“Idiopathic” is the medical term for diseases and conditions that have no known causes.)

What are the signs and symptoms of Pediatric Early Onset Scoliosis?

In addition to having a condition like the ones listed above, a child with early onset scoliosis may have symptoms that include:

• Appearance of leaning to one side
• One hip that sits higher than the other
• Protruding shoulder blade on one side
• Ribs appearing more prominent on one side
• In rare cases, weakness or numbness due to spinal cord compression

How is Pediatric Early Onset Scoliosis diagnosed?

When a child’s spine curves at an angle of 10 degrees or more, it’s considered scoliosis. Signs of early onset scoliosis may first be detected at home by parents, at scoliosis screenings that happen at many schools, or at wellness appointments as a child grows up.

When kids come to us with symptoms of scoliosis, first we do a simple physical exam to see them bend and stretch their spine. If we conclude they have scoliosis, then we’ll take an X-ray to get exact images of your child’s spine and help us decide what kind of treatment they’ll need. We take X-rays periodically during your child’s treatment, so we use a machine that uses extra low doses of radiation.

What causes Pediatric Early Onset Scoliosis?

There are multiple causes for early onset scoliosis (see the different types listed near the top of this page). Often it is caused by another disease or disorder, such as spina bifida.

How is Pediatric Early Onset Scoliosis treated?

Most cases of early onset scoliosis resolve on their own before age two. But the angle of a spinal curve may increase as long as the child is growing (until age 16 or older). After diagnosing scoliosis, we measure the curve of a child’s spine every six to 12 months to see what kind of treatment they need. Treatments include:

• Monitoring: If your child has moderate scoliosis (a curve of less than 25 degrees), our only treatment is to take periodic X-rays and see how much the curvature increases over time. If your child’s scoliosis remains moderate throughout their growth, it won’t affect their health and activity and they won’t need treatment.
• Bracing: When scoliosis is more pronounced, we work with a prosthetics company to create a custom brace for your child. The brace keeps your child’s spinal curve from getting worse as they grow.
• Casting: In even more pronounced cases, we will fit the child with a Mehta cast. These are plaster casts similar to the casts kids get when they break their arm, except the Mehta cast is shaped like a harness. It has a solid back, with one rim that wraps to the front across the hips and another that goes under the arms across the chest. Mehta casts decrease the angle of your child’s spinal curve as they grow. Your child will get a new cast every two to three months, over a span of six to 18 months, depending on the growth of their spine during treatment. Although the cast shouldn’t get wet, children with Mehta casts can run and do most activities without any trouble.
• Surgery: To treat severe cases, we may do an operation to attach “growing rods” to your child’s spine. These are extendable rods designed to lengthen as your child grows to help straighten their spine. We use special rods called Magec rods, which extend with magnets we apply outside the body. This means we can adjust the rods without surgery.