Overview
Congenital scoliosis curves develop because some of the bones in the spine don’t form or separate correctly during prenatal development (before birth). In this type of scoliosis, babies are born with abnormal bones and/or growth plates in the spine. The curve may not appear immediately, but the abnormal bones or growth plates may cause a curve as the child grows. Congenital scoliosis happens in 1 in 10,000 babies and can be associated with other problems with some of the internal organs (such as the kidneys, heart, spinal cord, airway, and intestines).
As a baby is developing and all the organ systems are forming, the bones that will protect the spinal cord are also being formed. If they don’t form completely they may cause a curvature of the spine.
Your body can move, twist and bend because there are discs between each level of the spine which allows them to move. Sometimes these discs are missing and the spinal levels are fused. This can also cause a curvature of the spine in some children.
Some children will have both improperly formed bones and improperly fused bones.
Symptoms
Congenital scoliosis is not painful. Like any spine curve, you may notice your child has one shoulder or shoulder blade higher or more prominent than the other. Your child may appear to lean to one side. You may notice creases in the skin on one side of the trunk or waist. Because the problem starts before a baby is born when bones and organs were forming at the same time, there is a chance that other body parts could also have developed abnormally and should be checked.
Examination & Evaluation
If the pediatrician is concerned with a congenital scoliosis he or she will send you to see a pediatric orthopaedic surgeon who specializes in this type of problem. The doctor will check the back for birthmarks, hairy patches or dimples in the skin. The doctor will also examine your child’s muscle function, ability to feel touch, and reflexes.
A child may need other testing such as X-rays, ultrasounds, and an MRI. In some cases, your child may need an echocardiogram, which is an ultrasound of the heart. Your doctor will want to know more about the bones and growth plates in the spine as well as other parts of the body that were developing at the same time as the spine. Your child will likely have an MRI which uses a magnet to get images of the body. In small children, this is often done with anesthesia.
Treatment
Because each child with congenital scoliosis can have a different type of curve in the spine, treatment is specific for each child. In very young children, scoliosis is often observed. Your child may have regular visits every 6 to 12 months with an orthopaedic doctor to monitor your child’s curve. Bracing or casting is sometimes used for congenital scoliosis to slow down progression of the curve. Surgery for congenital scoliosis may be recommended for some children. Your surgeon will carefully plan the type and timing of surgery. In children who are still growing, surgery may be performed at just the levels of the spine with abnormal bones. Other surgeries that may be recommended allow for the spine and chest to continue growing. Sometimes bigger surgeries are needed, but these are done when a child’s body is closer to the end of his or her growth. Spine surgeries are done to prevent the spinal curve from affecting heart, lung, or spinal cord function later in life.
Any concerns about this process should be discussed with your doctor. This can seem overwhelming, but your medical team will help you with every step.
Prognosis
Because each type of congenital scoliosis is different, the treatment for each child will vary. A child’s outcome depends on the type of curve that he or she has and the type of treatment that is needed.
Q. What is congenital scoliosis? What causes it?
Congenital scoliosis is a curve of the spine caused by abnormal bones in the spine.
Congenital scoliosis curves develop because some of the bones in the spine don’t form or separate correctly during prenatal development (before birth). In this type of scoliosis, babies are born with abnormal bones and/or growth plates in the spine. The curve may not appear immediately, but the abnormal bones or growth plates may cause a curve as the child grows.
As a baby is developing and all the organ systems are forming, the bones that will protect the spinal cord are also being formed. If they don’t form completely they may cause a curvature of the spine.
Your body can move, twist and bend because there are discs between each level of the spine which allows them to move. Sometimes these discs are missing and the spinal levels are fused. This can also cause a curvature of the spine in some children.
Some children will have both improperly formed bones and improperly fused bones.
Q. How common is congenital scoliosis?
Congenital scoliosis happens in 1 in 10,000 babies and can be associated with other problems with some of the internal organs (such as the kidneys, heart, spinal cord, airway, and intestines).
Q. What are the symptoms of congenital scoliosis?
Congenital scoliosis is not painful. Like any spine curve, you may notice your child has one shoulder or shoulder blade higher or more prominent than the other. Your child may appear to lean to one side. You may notice creases in the skin on one side of the trunk or waist. Because the problem starts before a baby is born when bones and organs were forming at the same time, there is a chance that other body parts could also have developed abnormally and should be checked.
Q. How is this diagnosed?
If the pediatrician is concerned with a congenital scoliosis he or she will send you to see a pediatric orthopaedic surgeon who specializes in this type of problem. The doctor will check the back for birthmarks, hairy patches or dimples in the skin. The doctor will also examine your child’s muscle function, ability to feel touch, and reflexes.
A child may need other testing such as X-rays, ultrasounds, and an MRI. In some cases, your child may need an echocardiogram, which is an ultrasound of the heart. Your doctor will want to know more about the bones and growth plates in the spine as well as other parts of the body that were developing at the same time as the spine. Your child will likely have an MRI which uses a magnet to get images of the body. In small children, this is often done with anesthesia.
Q. How is this treated?
Because each child with congenital scoliosis can have a different type of curve in the spine, treatment is specific for each child. In very young children, scoliosis is often observed. Your child may have regular visits every 6 to 12 months with an orthopaedic doctor to monitor your child’s curve. Bracing or casting is sometimes used for congenital scoliosis to slow down progression of the curve. Surgery for congenital scoliosis may be recommended for some children. Your surgeon will carefully plan the type and timing of surgery. In children who are still growing, surgery may be performed at just the levels of the spine with abnormal bones. Other surgeries that may be recommended allow for the spine and chest to continue growing. Sometimes bigger surgeries are needed, but these are done when a child’s body is closer to the end of his or her growth. Spine surgeries are done to prevent the spinal curve from affecting heart, lung, or spinal cord function later in life.
Any concerns about this process should be discussed with your doctor. This can seem overwhelming, but your medical team will help you with every step.
Because each type of congenital scoliosis is different, the treatment for each child will vary. A child’s outcome depends on the type of curve that he or she has and the type of treatment that is needed.
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