Pediatric Orthopedics of SWF is a leader in the care of infants and children with Scoliosis and spinal deformities. The Scoliosis Center at Peds Ortho is staffed by an experienced team of experts committed to caring for young patients with specialized orthopedic needs.
Scoliosis is a medical condition in which a person’s spine is curved from side to side, shaped like a “s”, or may also be rotated like a “c”. It is typically classified as congenital (caused by anomalies present at birth), infantile or juvenile onset, or as having developed as a secondary symptom of another condition, such as cerebral palsy, spinal muscular atrophy or physical trauma.
Scoliosis can occur at any age and can run in families. Adolescent idiopathic scoliosis occurs after the age of 10. It is the most common type.
Infantile scoliosis occurs in children less than 3 years old. It may result from abnormally shaped vertebrae at birth (congenital), various syndromes, neurologic disorders, or unknown reasons (idiopathic).
In the case of the most common form of scoliosis, adolescent idiopathic scoliosis, there is no clear cause. Scoliosis often presents itself, or worsens, during the adolescence growth spurt.
The general rules of progression are that larger curves carry a higher risk of progression than smaller curves. In addition, patients who have not yet reached skeletal maturity have a higher likelihood of the curvature progressing.
The traditional medical management of scoliosis is complex and is determined by the severity of the curvature, skeletal maturity, which together help predict the likelihood of progression.
The conventional options are, in order:
Bracing is only done when the patient has bone growth remaining, and is generally implemented in order to hold the curve and prevent it from progressing to the point where surgery is necessary.
In infantile, and sometimes juvenile scoliosis, a plaster jacket applied early may be used instead of a brace.
Surgery is usually indicated for curves that have a high likelihood of progression, curves that cause a significant amount of pain with some regularity, curves that would be cosmetically unacceptable as an adult, curves in patients with spina bifida and cerebral palsy that interfere with sitting and care, and curves that affect physiological functions such as breathing.
Spinal fusion is the most widely performed surgery for scoliosis. In this procedure, bone (either harvested from elsewhere in the body [autograft], or donor bone [allograft]) is grafted to the vertebrae so that when it heals, they will form one solid bone mass and the vertebral column becomes rigid.
Modern spinal fusions generally have good outcomes with high degrees of correction and low rates of failure and infection. Patients with fused spines and permanent implants tend to have normal lives with unrestricted activities when they are younger. Most patients are able to participate in recreational athletics, have natural childbirth and are generally satisfied with their treatment.