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Congenital Scoliosis

What is congenital scoliosis?

The term Congenital Scoliosis refers to the deformity of the spine, which is created during intrauterine life (usually the 4th–6th week of pregnancy).

Congenital Scoliosis is distinguished into three types:

  1. 1.

    Congenital Scoliosis due to failure of vertebral formation

    This is the most common form of congenital scoliosis in which a part of the vertebrae does not develop.

     

  2. 2.

    Congenital Scoliosis due to failure of vertebral segmentation

    In this case, one or more vertebrae may be abnormally connected either through the transverse processes on one side (bony bars) or by complete fusion of the vertebrae, the so-called block vertebrae.

     

  3. 3.

    Congenital Scoliosis due to a combination of the two above causes

    In some cases, both of the above causes may be present.
    The presence of a congenital form of scoliosis may indicate other problems such as heart, kidney, or even gastrointestinal disorders which must be carefully investigated.

     

What are the symptoms of congenital scoliosis?

This condition can be detected during prenatal screening.
After birth, the symptoms that are apparent are:

  1. 1.

    Protrusion (hump) on the back side of the thorax

  2. 2.

    Asymmetry in the shoulders

  3. 3.

    Protrusion in the hip or waist

  4. 4.

    Tilting of the head to one side of the trunk

  5. 5.

    Pain in the lower back or back

  6. 6.

    Delay in standing and later in walking of the child

Congenital Scoliosis

What are the consequences if timely diagnosis is not made?

Congenital Scoliosis requires monitoring, otherwise it may rapidly worsen, creating severe deformity and pain while at the same time it may affect the function and development of the lungs. Congenital Scoliosis may also impact the child’s psychological state if the symptoms affect their appearance. Congenital Scoliosis may be associated with abnormalities in other parts of the body, such as the kidneys and the heart, therefore it is important to carry out a complete check of all systems when it is discovered.

What are the first steps if related symptoms of congenital scoliosis are observed?

Your pediatrician is the one to contact initially, so that a full history of the child can be taken and then a clinical examination can be performed. If alarming symptoms are identified, you will be referred to a specialized spine surgeon to perform an accurate diagnosis and full investigation and assessment of the condition.

 

Congenital Scoliosis

How is the diagnosis made?

Initially, the doctor will take a full medical history of the child. Then, they will proceed to examine the back, arms, and legs. Important for the diagnosis are spinal X-rays to measure the angle of scoliosis (Cobb angle). At the doctor’s discretion, additional tests such as MRI or CT scan may be needed.

The doctor may suggest examinations concerning other parts of the body that may be affected by congenital scoliosis, such as the heart, lungs, or the child’s urogenital system.

After completing the diagnosis, the doctor will assess whether regular visits to the clinic are required for monitoring.

    How is congenital scoliosis treated?

    Regular follow-up appointments

    Usually, Congenital Scoliosis requires monitoring with regular appointments to the Spine Surgeon. If the condition remains stable, this process is maintained until adulthood.

    Do not neglect physical exercise

    One way to enhance physical condition so that the quality of daily life is even better is physical exercise in order to strengthen the muscles of the trunk core. Official studies may not confirm that this contributes to improvement of the condition or that it halts a potentially deteriorating course, but it certainly works only to the benefit of the one exercising.

    Braces – Are they effective in congenital scoliosis?

    In the case of congenital scoliosis, their application is limited. In order to be as effective as possible, they must be worn 23 hours a day and removed during personal hygiene and exercise.

    Surgical intervention

    Usually, Congenital Scoliosis is managed by regular monitoring of the child’s condition. If the doctor assesses that the condition shows serious worsening, then surgical intervention may be performed. In this way, proper development of the spine is ensured and the condition will not relapse.
    If the doctor deems that surgery is needed, this can be performed either by:

    • Hemiepiphysiodesis: In this operation, detection and destruction of the abnormal growth areas takes place. Thus, these areas do not develop, while during the remaining time the normal growth may correct the problem.
    • Hemivertebra excision: The goal is to stabilize the condition by removing the abnormal vertebra and fusing a small segment of the spine.
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