Congenital scoliosis

Congenital scoliosis is defined as a curvature of the spine that is the result of malformations of the vertebral elements. The fact that the spine and spinal column ever form correctly is amazing given the complexity of the process from an embryological standpoint. Most of this development happens during the third to sixth week in utero (after conception). In spite of the opportunities for error, congenital malformations are relatively rare.


The elements of the spinal column develop at the same time as several other major organ systems such as the bladder, kidneys, and heart. As a result, there is an association between congenital vertebral anomalies and other malformations. For example, there is a 20% incidence of associated genitourinary anomalies in children with congenital scoliosis. Malformations of the spinal cord are also common, and medical attention should be sought if there is any suggestion of an intraspinal problem such as dimples or hairy patches over the skin of the back, pain, or spasticity in the lower extremities.
If your child is thought to have congenital scoliosis, the evaluation should begin with a thorough physical examination in search of associated congenital anomalies. Taking x-rays of the entire spine will determine if congenital scoliosis is present. X-rays will also allow your doctor to determine the type and severity of the congenital vertebral malformations, which helps predict the long-term risk that your child's curve may get worse with growth. A renal ultrasound is usually recommended as part of the routine screening assessment if congenital scoliosis has been confirmed. An MRI of the spinal cord may be indicated if there is suspicion of a spinal cord abnormality or unexplained rapid progression of the curve.
Doctors think about congenital scoliosis in three groups: failures of formation, failures of segmentation, and combinations of these defects. The most common failure of formation is called a hemivertebra. Hemivertebra produce a growth imbalance in the spine and, therefore, result in the spine growing crooked. Failures of segmentation include block vertebra and unilateral bars, which produce a growth tether of the spine. Finally, when these occur in combination, such as a hemivertebra on one side and a bar on the other, the scoliosis can progress in very rapid manner.
When your doctor recommends a treatment plan for congenital scoliosis, it is based on the prediction of the potential abnormal growth associated with your child's particular pattern of spinal malformations. Some patterns of congenital scoliosis have a low potential for significant progression with growth, whereas others will progress aggressively at a very early age. Each pattern of malformation is unique and a treatment plan is made based on the risk of curve progression during growth.
Treatment options in congenital scoliosis include observation, bracing, or surgery. The goals of treatment are to allow the child to reach the end of growth with a reasonably straight, balanced spine, and to allow the spine to grow as much as possible. For younger children, allowing for the chest cavity to grow and develop and allowing the lungs to increase in size is becoming increasingly recognized as an important consideration in the overall treatment plan.

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What is scoliosis and what causes it?

Scoliosis is an unhealthy curvature of a normally straight spine, affecting 12 million people worldwide. A rotation of the vertebra and the rib cage usually accompanies this unhealthy curve. Left untreated, this unhealthy curve can worsen and cause disfigurement, respiratory and digestive problems, and debilitating pain. Most scoliosis patients are diagnosed between ages 12 and 16, although there are many adults who suffer from the disease as well.
Scoliosis is a progressive disease which can continue to progress into maturity. As such, it is a disease that must be monitored aggressively.
The unhealthy curve may be slight or significant, and may include the lumbar (lower spine), thoracic (middle spine), or thoracolumbar (both middle and lower spine). The cause of scoliosis is complex; potential contributing factors may include other diseases, trauma, or injuries. Idiopathic scoliosis is one of the most common types of scoliosis; the cause is unknown.

Scoliosis in Adults

Many adults suffer from scoliosis, typically as a progression of the disease from childhood. However, degenerative changes in the spine can cause scoliosis in otherwise healthy adults. These incidents may have been initiated through trauma or disease such as fractures, osteoporosis, or degenerative disc conditions. Noticeable changes often include:

Rib hump
Low hip
Low pelvis
Leg length discrepancies

Some scoliosis patients have breathing difficulty and neuropathy. Since many early degenerative changes are shown in younger patients, adults often have severely advanced degenerative changes on the spine.

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Provides relief from muscular strain do to chronic postural changes

Provides relief of chronic pain

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