Congenital scoliosis is an abnormal curvature in the spine caused by one or more birth defects that affect growth. Most instances of scoliosis are not noticed until later childhood or teenage years, when growth spurts make the curvature more obvious. Many individuals with mild congenital scoliosis are able to lead normal lives and enjoy activities with no adverse health effects, though severely curved spines can present difficulties in mobility and may lead to heart or lung problems. Treatment usually involves surgery to fuse vertebrae together, preventing the spine from becoming more out of place.
There are two main types of congenital scoliosis. A unilateral bar occurs when two or more vertebrae that have grown together on one side of the spine, leading to slouched posture and one prominent shoulder blade. The other common type of scoliosis, hemivertebra, refers to a vertebra that has only developed on one side, which often causes one shoulder or hip to rest higher than the other one. Doctors are uncertain why unilateral bars and hemivertebra occur, but research shows that malformations usually begin around the fourth week in utero. Unless a spine is severely malformed at birth, congenital scoliosis is not normally diagnosed until later in life.
Children and their parents usually begin to notice signs of scoliosis by the teenage years, when growth spurts have caused the condition become worse or more prominent. It is rare for a person to experience pain with the condition. A doctor will conduct a thorough physical examination, take x-rays of the spine, and check for the presence of lung, kidney, liver, or heart defects. Once a diagnosis of congenital scoliosis has been made, the physician will consider the severity of the problem and determine whether or not the condition is progressing. Signs that curvature may worsen usually necessitate surgery.
The most common surgery for congenital scoliosis involves making an incision along the back and fusing vertebrae together along the curve. When the bones are connected, they are prevented from growing and further misaligning the spine. A surgeon may also choose to remove a hemivertebra to straighten out the spinal column. Most surgeons fit patients with braces or casts after procedures in order to protect the spine and allow it time to heal properly. In the majority of cases, no further surgeries or treatment procedures are necessary.
Experts usually suggest that individuals living with congenital scoliosis schedule regular checkups with their physicians to monitor the condition. Periodic x-ray screenings can confirm that curvature does not continue to worsen over time. It is possible for back pain or breathing problems to arise during adulthood, but most people who receive the appropriate treatment are able to enjoy normal, active lifestyles.