Infantile (Early Onset) Scoliosis

Idiopathic infantile (early onset) scoliosis generally occurs in children under the age of four.

Diagnosis

Physical exams, X-rays, CT scans, MRIs or a combination of these tests are used to diagnosis early-onset scoliosis. A small child will often need to be sedated or receive general anesthesia to keep still enough to get the best images to make a diagnosis.

Treatment

  • Observation: This is typically the first type of treatment used in early onset scoliosis. During this phase, our doctors will use periodic X-rays, CT scans and MRIs to monitor how quickly the curvature progresses. The doctor might also order bending radiographs to test the curve’s flexibility.
  • Casting and bracing: Depending on the child’s age and the curve’s flexibility, casting or bracing might be used for early onset scoliosis if the spine curvature is progressing. Casting is used on smaller children, with the hope of slowing the curve’s progression until the child can move on to a brace. The brace is used for the same purpose: to slow the curve’s progression until surgery is done to permanently correct the curve.
  • Surgery: This is a last resort in the treatment approach. Learn about our advanced surgical options.

Learn more about treatment methods for scoliosis

Adolescent Scoliosis

Scoliosis in patients between ages 10 and 18 is called adolescent idiopathic scoliosis (AIS).

AIS is the most common form of scoliosis and happens in about 3 percent of the general population.

Causes and symptoms

Scoliosis is usually noticed during routine health exams or as a part of a school’s screening program.  

When a child’s bones are fully mature, the risk of progression then depends on the degree of curvature at maturity.

One study (Collis and Ponseti) found: 

  • A thoracic curve less than 30 degrees at skeletal maturity is zero percent likely to progress.
  • A thoracic curve greater than 60 degrees at skeletal maturity is 100 percent likely to progress.
  • Curves between 30 and 60 degrees have a variable rate of progression.
    • Curves closer to 30 degrees are closer to zero percent likely to progress.
    • Curves closer to 60 degrees are closer to 100 percent likely to progress.

Diagnosis

The physical exam for scoliosis involves observing the patient from the front and the back, and noting certain asymmetries (unevenness) in the shoulders, hips, chest and torso. 

  1. The examiner looks for midline defects such as dimples and hairy patches, and hyper- or hypopigmented skin lesions.
  2. Your child is asked to bend forward with arms dangling freely (Adams forward bend test). This position helps your child’s doctor see any lower back asymmetry as well as rib cage prominence (one side higher than the other).
  3. After the exam, your child’s doctor will look at the child’s limb lengths and do a neurologic (nervous system) exam. 

Treatment

Learn more about the treatment methods for scoliosis