Scoliosis is a spine deformity that causes the spine to twist and curve in an abnormal fashion. The most pronounced type of abnormal curve usually is a sideways curve in which the spine is slightly S-shaped, but curvature rarely is two-dimensional, and the spine often curves slightly from front to back as well. There are several types of scoliosis, including adolescent, juvenile and infantile scoliosis, congenital scoliosis and neuromuscular scoliosis. Infantile scoliosis is defined as that which occurs in children under the age of 3.
For all types of scoliosis, including infantile scoliosis, approximately 80 percent of cases do not have any apparent cause. These are referred to as cases of idiopathic scoliosis. For cases with a definite cause, the most likely causes are genetic conditions, congenital spine abnormalities and neuromuscular disorders. Each of these three causes can result in curvature of the spine that is apparent at birth; sometimes the curvature might not become apparent for several months or years, or even until the child enters adolescence.
Infantile scoliosis is a rare type of scoliosis with a variable frequency around the world. In the United States, for example, the frequency of this type is around one percent of all idiopathic cases. In Europe, this type accounts for four percent of idiopathic cases. Six out of every 10 cases affect males. In most cases, this early onset scoliosis will resolve itself without treatment. In about 10 percent of cases, however, there is the potential for progression into very severe spinal curvature that can be profoundly disabling.
There are three different options for managing infantile scoliosis: monitoring without treatment, surgery and using an orthotic device to correct abnormal curvature over time. When the degree of curvature is less than 20 degrees, the typical management option is to monitor the condition without treating it. A child with this degree of spinal curvature therefore is monitored every four to six months for signs of more pronounced curvature.
For more pronounced or progressive curvature, a back brace is commonly used to correct the curve. This orthotic device, typically a custom-molded brace made of hard plastic plates and metal, must be worn almost 24 hours a day. Generally, the child is advised to remove the brace only when exercising, swimming or bathing. Depending on the age of diagnosis, the brace might be worn for several years, because a child must wear the brace until his or her skeleton has matured enough to prevent progressive curvature. Even so, in severe cases, it is possible for curvature to progress despite the use of a back brace.
Children younger than 10 with infantile scoliosis are generally considered too young to undergo scoliosis surgery, because of the rapid rate of bone growth in children of this age. Once a child reaches the age of 10, surgery might be attempted, depending on the degree of spinal curvature. Surgical treatment involves the fixation of metal rods to the abnormally curved portions of the spine in order to prevent further curvature as the bones grow. This surgery generally must be repeated every six months until the child reaches the age of 15, in order to accommodate bone growth.
