Pediatric Congenital Conditions Scoliosis

Scoliosis, a condition marked by any abnormal spinal curvature, is relatively common. While 3 percent of all children have some degree of scoliosis, up to five out of every 1,000 children require treatment for their scoliosis. While scoliosis treatment usually involves wearing a brace, severe cases may require surgical correction.

Scoliosis Causes

Here are some of the various causes of scoliosis:

  • Genetics: Doctors know that scoliosis runs in families. When genetics is the cause of scoliosis, the condition is known as congential scoliosis. Congenital scoliosis, cases in which scoliosis is present from birth, is associated with vertebrae formation problems in the developing fetus.
  • Neuromuscular conditions: Health problems such as cerebral palsy, polio, spina bifida and muscular dystrophy can all cause scoliosis as a secondary complication of these more serious underlying disorders.
  • Unknown causes: Many scoliosis cases have unknown causes. Known as idiopathic scoliosis, spinal curvature with no known cause is most common in teenage girls.

Scoliosis Symptoms

Scoliosis symptoms can be difficult to detect depending on the degree of misalignment in the spine. For example, spinal curvature may result in one shoulder being lower than the other or the pelvis being tilted. However, unless scoliosis in children is very severe it is likely most people will miss these scoliosis symptoms.

The greater the degree of spinal curvature, the more evident scoliosis symptoms. Severe scoliosis in children can cause backaches, lower back pain and fatigue. In the worst cases, scoliosis can result in difficulty breathing, as the spinal curvature places pressure on the respiratory system.

Diagnosing Scoliosis in Children

Scoliosis screening is increasingly common in middle and junior high schools across America. Screening involves a simple bending test to check the degree of spinal curvature.

If screening indicates scoliosis in children, further testing may be required. X-rays of the spine will then be taken from the back and the sides. A neurological exam may be needed to evaluate reflexes, sensation and other neurological factors. The spinal curve itself is measured with a device known as a scoliometer.

Teens with spinal curves of less than 25 do not necessarily require treatment. Instead, these mild cases of scoliosis are typically monitored for any changes during regular checkups.

Scoliosis Treatment: Braces

When a scoliometer measures curvatures that are 25 to 30, patients will need to wear scoliosis braces. Scoliosis braces are melded braces that put pressure on the spine and encourage normal spinal development.

In earlier times, scoliosis braces were heavy, uncomfortable and, from an adolescent’s point of view, embarrassingly obvious. However, technological advancements have made these braces far lighter and much less conspicuous than their forerunners. Several scoliosis braces can easily be worn under clothes, making adolescents feel less self-conscious.

To effectively treat scoliosis in children, scoliosis braces must be worn for the full amount of time recommended by doctors. This generally means that children need to spend several hours a day in scoliosis braces.

Even with advances in scoliosis treatment, children may develop emotional problems and low self-esteem from wearing scoliosis braces and living with abnormal spinal curve. Counseling is sometimes recommended to help children deal with the emotional issues associated with scoliosis.

While idiopathic scoliosis responds best to bracing, congenital scoliosis is often severe and requires multiple surgeries.

Scoliosis Surgery

Scoliosis surgery is recommended if the spinal curve exceeds 40. When the spine has curved this dramatically, scoliosis is likely to continue to worsen until the child has finished growing.

In scoliosis surgery, the affected vertebrae are fused together to prevent scoliosis from worsening. The vertebrae are then held in place with metal bars until the bone heals. These metal bars, which are not removed after scoliosis surgery, remain hidden in the body for the rest of the child’s life. Because scoliosis surgery can’t fully correct the spinal curve, the remaining abnormal curvature is corrected with scoliosis braces.

Children with scoliosis symptoms that stem from neuromuscular conditions may require surgery or braces to alleviate symptoms. However, scoliosis treatment will not treat the underlying condition. Consequently, the more serious condition causing scoliosis must also be treated separately.

Resources

eMedicine Health (updated June 5, 2007). Scoliosis. Retrieved September 19, 2007 from the eMedicine Health Web site: http://www.emedicinehealth.com/scoliosis/article_em.htm.

U.S. Library of Medicine (updated 28 April, 2004). Scoliosis. Retrieved June 5, 2005 from the NLM Web site: www.nlm.nih.gov/medlineplus/ency/article/001241.htm.