Managing Scoliosis in Young Children

Scoliosis or curvature of the spine can affect young children under the age of five. In this article doctors from the Naval Medical Center in San Diego review what causes this condition and how to treat it. Newer surgical methods of treatment are highlighted. Details of the exam are also included.

Although some cases of early onset scoliosis occur for no apparent reason, most are caused by some other problem. This could be deformity of the vertebra, muscular dystrophy, cerebral palsy, or some other neurologic condition.

MRIs should be done with all young patients whose curves measure 20 degrees or more. The authors suggest this because many of the young children with scoliosis also have hidden spinal cord or brain abnormalities.

Treatment depends on the size of the curve. Curves less than 20 degrees are followed with X-rays every four to six months. If the curve stabilizes, then an exam every one to two years is enough. For curves greater than 20 degrees casting, bracing, or both is advised for at least two years.

If a curve continues to get worse, then surgery to fuse the spine may be needed. The spine does stop growing when fused so this is not the best solution. Another option is the use of “growing rods.” Rods are placed on both sides of the spine. The rods are lengthened every six months as the child grows. fusion can be delayed until much later.

What’s ahead in the treatment of this problem? The authors say the search is on for better ways to correct the curve and keep it from getting worse. Less invasive and fewer operations is a goal. Remote control implants have been tried on dogs. Preserving spinal growth and lung function is important in this age group.