Scoliosis is an abnormal curvature of the spine. Idiopathic scoliosis means the cause of the curvature is unknown. Sometimes scoliosis is the result of a neuromuscular disorder such as cerebral palsy or muscular dystrophy.
Idiopathic early-onset scoliosis (EOS) is a curvature that occurs in young children (under age five) for no apparent reason. The curve can progress rapidly causing rotation of the ribs and chest. This twisting squashes the organs (e.g., heart, liver, lung) and compromises their function.
In young children, surgeons try to avoid spinal fusion because the child is growing. Many favor the use of serial casting to realign and hold the spine as the child grows. Sometimes halo-traction is used first to pull the vertebral (spinal) bones apart and lengthen the spine as much as possible before putting a cast on to hold the spine in place.
Reversing the spinal deformity using these nonoperative techniques is more likely to work in younger children (under age three). Older children with severe curves may be treated using something referred to as “growing rods”. These metal rods placed alongside the spine to hold it in place are telescoped and can be lengthened to “grow” as the child grows.
The intent of treatment for early onset scoliosis (EOS) is to keep the spine as straight as possible using nonoperative approaches until fusion can be done. Each child is evaluated individually and decisions made in the best way possible with the information currently available.