Scoliosis can develop very early on in childhood.

Types

There are several different types of early onset scoliosis

Infantile idiopathic scoliosis

“Idiopathic” means of unknown cause. Idiopathic scoliosis is when the spine is curved sideways but there is no known cause of this curvature. Infantile idiopathic scoliosis occurs in children between birth and up to 3 years of age.

Juvenile idiopathic scoliosis

JIS occurs in children between the ages of 4-10 years old. Similar to infantile idiopathic scoliosis, there is no known cause.

Congenital scoliosis

Congenital scoliosis is a spine deformity caused by vertebrae that are not properly formed in utero. There can be medical conditions associated with congenital scoliosis. It can present in infancy, childhood or adolescence. Your orthopedic surgeon will be able to tell you if a hemivertebra (partial vertebra) is present or if the vertebrae are joined together abnormally.

Treatment

As children grow, they will have many follow up visits with the orthopedic doctor to monitor the progress of the spine curve. The doctor will make recommendations at each visit. These individualized recommendations can include ongoing observation with a) either an x-ray and/or physical exam b) a course of bracing or c) discussion about the need for surgery.

At some point, the doctor may feel it is necessary to perform other tests which will give them more information about the structure and development of the spine. These include:

• A CT scan (PDF) (a form of x-ray using computerized tomography) which shows three-dimensional reconstruction of the spine. This gives the surgeon more accurate information if surgery is required.
• An MRI (PDF) of the spinal cord (a non-invasive medical imaging procedure which uses a powerful magnet that provides detailed three dimensional images of soft tissues) which would show the spinal canal and rule out any abnormalities.

Growth-friendly surgery

If the doctor determines that surgery is the best treatment course for a child with scoliosis, they may discuss several options in order to help guide the growth of the spine as a child continues to grow.

This will require multiple surgeries over time:

• the initial placement of the guided growth device
• subsequent lengthenings to continually assist the spine to grow straight as the child grows.

There are two different types of guided growth devices.

Growing rods

Growing rods use implanted hooks, screws and expandable rods attached to the spine which control the spinal curve and allow for the spine to grow. Growing rods need to be lengthened approximately every 6 months. Eventually a more permanent spinal fusion will become necessary which halts growth in the area of instrumentation.

A follow-up appointment will be required to remove the stitches after each lengthening.

VEPTR (vertical expandable prosthetic titanium rib)

A VEPTR is a type of device used for the treatment of thoracic insufficiency syndrome involving rib and spine deformities. These devices can be attached to the ribs, pelvis, or spine. A limited number of patients are appropriate for this type of lengthening option. As with the growing rods, small incisions are required to do the lengthening approximately every 6 months. A follow up appointment will be required to remove the stitches after each lengthening.

Pamphlets

• About Scoliosis and the BCCH Spine Clinic (PDF)
• Scoliosis Booklet- Your Spine Surgery, Posterior Fusion (PDF)
• Scoliosis Booklet- Your Spine Surgery, Neuromuscular Scoliosis (PDF)
• Bracing Handout (PDF)
• Halo Thoracic Brace (PDF)
• C-Spine Clearance Guidelines (PDF)
• The Growing Spine: What's ahead for my young child with scoliosis? (PDF)