Pediatric Scoliosis: Causes, Symptoms And Treatment

Scoliosis can be defined as the development of an abnormal spine curvature due to excessive rotation between the vertebrae. When this condition affects adolescents and children, it is classified as Pediatric Scoliosis. It is most commonly seen in the thoracic region of the spine. Depending upon its cause, the condition can be categorized as:

  • Congenital Scoliosis– This type of scoliosis is present at the time of birth
  • Idiopathic Scoliosis– It has no apparent cause but is diagnosed in children with one or more family members having Scoliosis
  • Neuromuscular Scoliosis– Patients suffering from medical conditions that cause abnormalities in the spinal nerves and muscles develop this category of Scoliosis

Pediatric Scoliosis may range from mild (less than 25 degrees of curvature) to severe (more than 45 degree curvature) with total spinal deformity. The former one generally does not require treatment except for regular monitoring to check the progression of the condition. Severe cases of Pediatric Scoliosis however need proper treatment.

Causes

  • Genetic factors may promote development of Pediatric Scoliosis
  • Improper development of the vertebrae or inability of the bones to fuse properly in the embryonic stage.
  • Trauma caused to the child at the time of birth or during the gestation period may also be a cause
  • Neuromuscular disorders such as Muscular Dystrophy, Cerebral Palsy, Spina Bifida etc. may result in abnormal spine curvature as in this case the muscles are weak and cannot lend stability to the spinal cord
  • Strain on the abdominal muscles may cause the spine to develop an abnormal curve

Symptoms

  • The typical symptoms of Pediatric Scoliosis may be one or more of the following
  • Unevenness in the level of right and left shoulder
  • The child may tend to lean to one side of the body
  • The hip and waist may be elevated on one side
  • The child may limp while walking
  • Fatigue may be experienced while performing physical tasks
  • Some cases may show changes in skin color around the affected part of the spine

Diagnosis

  • A detailed evaluation of the child’s medical and family history
  • Physical examination to check for the changes or abnormalities in the shape as well as angle of the chest, legs, shoulders, hips, legs, waist and pelvis
  • Adam’s forward bend test – The child may be asked to bend forward to view the shape of the spine and changes in rib cage, if any
  • The length of the limbs may be measured
  • X-ray imaging may be required cases to assess the bone structure

Treatment

  • The treatment option depends on the degree of curvature and the child’s age which indicates the growth years remaining to attain structural maturity.
  • Regular monitoring for 4-6 months may be recommended for mild cases of Pediatric Scoliosis to check if the condition is stable or progressive
  • Customized braces may be worn under the clothes to keep the spine stable. It may help to prevent the condition from progressing and is generally recommended if the curve is between 25 and 45 degrees
  • A Scoliotic curve that is progressive and larger than 45 degrees may require surgical intervention. This is done to fuse the affected vertebrae in order to stop the progression of the condition
  • Surgical realignment of the vertebrae may be done and the spine may be held in a normal position by inserting metal rods, screws or pins

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