Congenital Scoliosis Symptoms Causes

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At Boston Children's Hospital, our Spinal Program team develops innovative treatments for scoliosis and other spine problems. And because our research informs our treatment, we’re known for our science-driven, experience-based approach.

We’re home to the world’s most extensive pediatric hospital research enterprise, and we partner with elite health care and biotech organizations around the globe. But as specialists in innovative, family-centered care, our physicians never forget that your child is precious, and not just a patient.

In dealing with your child’s scoliosis, you may want to know the basics about the spine and about the several forms of this spinal problem.

What is the spine?

Made up of many individual bones called vertebrae, the spine is joined together by muscles and ligaments. Flat, soft discs separate and cushion each vertebra from the next. Because the vertebrae are separate, the spine is flexible and can bend. Together the vertebrae, discs, muscles and ligaments make up the spine or vertebral column.

Different regions of the spine are named differently. The cervical spine refers to the neck, the thoracic spine to the chest, and the lumbar and sacral spines to the lower back.

What is scoliosis?

Although the spine has natural curves from front to back, it shouldn’t curve sideways very much. A side-to-side curve measuring 10 degrees or greater is called scoliosis, and may take the shape of an abnormal “S” (double curve) or a long “C” (single curve). The scoliotic spine is also rotated or twisted, pulling the ribs along with it to form a multi-dimensional curve. In serious cases, lung function can be affected.

Can my child's spine curve progress (worsen) over time?

Curves can progress most aggressively (fast) during a child’s two main growth spurts:

•    at one to three years
•    pre-adolescent

The type and severity of your child's curve can help predict the risk of the curve progressing as a child grows. Some curve patterns progress slowly, while some progress very aggressively (especially in younger children).

Will my child be OK?

The outlook for your child greatly depends on the nature and severity of his congenital scoliosis, as well as any other accompanying conditions:

•   Many children function perfectly normally.
•   Commonly, the spine is shorter than normal, even if treatment isn’t needed.
•   The spine is stiffer than normal.
          -  The degree of stiffness is relative to how much of the spine is involved.
          -  Fusion makes the spine stiffer.
          -   For some children, this is visible and dictates restricted activities.
•   For some children with early, severe curves, breathing may be affected.

With successful spine surgery and attentive post-operative care, he can have a spine that grows as normally as possible, with greater torso length than if he hadn’t been untreated.

When to seek medical advice for congenital scoliosis

Consult your doctor if you notice that your child’s:

•   shoulders are of uneven heights  
•   head isn’t centered with the rest of his body
•   hips are of uneven heights or positions
•   shoulder blades are of uneven heights or positions
•   arms hang beside his body unevenly
•   left and right sides of his back appear different in height when he bends forward

Also, consult your doctor is your child:

•   has problems with his genitourinary tract
•   has breathing difficulty
•   has rapid or irregular heartbeat
•   has an irregularly shaped hand, arm or foot

Questions to ask your doctor

If your child is diagnosed with congenital scoliosis, you may feel overwhelmed with information. It can be easy to lose track of the questions that occur to you. Lots of parents find it helpful to jot down questions as they arise—that way, when you talk to your child’s doctors, you can be sure that all of your concerns are addressed.

Some of the questions you may want to ask include:

•   What is happening to my child, and why?
•   Are other tests needed to diagnose my child?
•   What actions might you take after you reach a diagnosis?
•   What will happen with growth over time?
•   Will there be restrictions on my child’s activities?  
•   Will there be long-term effects?
•   What can we do at home?

Who’s at risk for congenital scoliosis?

Congenital scoliosis is not thought to be an inherited disease and doesn't tend to run in families. Research studies continue, but there’s currently no reliable way to predict who will develop the condition.

For teens

Besides the typical issues all teenagers face—from social acceptance to body changes and more—if you have scoliosis and possibly another associated health problem, you’ll also have to deal with medical appointments, feeling different and assuming a big personal responsibility for maintaining your health. You may also wonder why you need surgery.

It’s important for you to know that surgery for your scoliosis will fuse your spine to help correct the curve and prevent further curvature. You’ll also probably grow somewhat taller than if you hadn’t been treated.

Even knowing the benefits of surgery and treatments, you might find this to be a tough time. If you feel overwhelmed, depressed or anxious during this important time in your transition to adulthood, speak to your doctor or counselor to get help.

Congenital scoliosis glossary

Learn more about scoliosis in our spine program glossary.
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