Infantile Scoliosis

Infantile idiopathic scoliosis is the name given to idiopathic scoliosis cases which are diagnosed in children between the ages of 0 to 3 years. Statistically, it is the least common of all forms of idiopathic scoliosis and comprises about 1% of all idiopathic scoliosis in children. Unlike most forms of Scoliosis infantile scoliosis is more common in males – about 60% of patients are boys.

What is infantile scoliosis?

Infantile scoliosis causes a curvature of the spine of an infant. There are two main theories as to the development of infantile scoliosis – the first postulates that some children are simply born with a spine which is already curved, while the second suggests that the curvature occurs after birth and may be linked to the way a baby is handled. Much more research is required to clarify this however, and it is likely that once idiopathic scoliosis itself is better understood, the answer will become clear.

Since most idiopathic scoliosis cases do develop later in life however, it is important that suspected cases in infants should be investigated with a complete neurological examination and MRI or CT scan. This will serve to rule out any underlying neurological condition or disease process.

What are the symptoms of infantile idiopathic scoliosis ?

Like most forms of scoliosis, the visual symptoms of scoliosis often only become visible after scoliosis has progressed to a noticeable degree. Other symptoms may include slower than expected gain in height or back pain.

How is infantile scoliosis treated?

Where infantile scoliosis is found not to be related to an underlying condition, the treatment options are generally the same as other types of idiopathic scoliosis.  There are two exceptions, however –

Firstly, it is true that many cases of infantile scoliosis will resolve without treatment, this is especially the case where the scoliosis may have developed due to uneven growth.

Secondly, in mild cases of infantile scoliosis (less than 20 degrees Cobb angle) observation (which would usually be inappropriate) may be worth considering, given the chance of the condition improving on its own in very young children.

For larger curves, the chances of a spontaneous resolution are lower, but here the same treatment options which apply to scoliosis at other ages can be effective.

In flexible curves over 20 degrees, full time bracing can be used, generally for 2 to 3 years and then reviewed as growth stabilises. In more rigid curves, repeated serial casting is sometimes recommended to help minimize the development of scoliosis and the possible need for surgery.

Surgery is always the last choice of treatment for infantile scoliosis; however, it may be recommended if bracing and casting fail to stop the scoliosis from progressing.

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