Scoliosis

Early onset scoliosis is found in children younger than 10 years of age. Types of early onset scoliosis includes:

• congenital scoliosis: where the spine forms abnormally before birth.
• infantile idiopathic scoliosis: occurs before the age of three, tends to affect boys more than girls, and usually resolves on its own.
• juvenile idiopathic scoliosis: occurs between the ages of three and nine, and there is a high risk that the condition will progress.

Adolescent idiopathic scoliosis affects children between the age of 10 and 18, and tends to affect more girls than boys.

Neuromuscular scoliosis affects children with Neuromuscular conditions, such as cerebral palsy, spina bifida or muscular dystrophy, which affect the nerves and muscles.

Syndromic scoliosis is a type of scoliosis that occurs as part of a broader medical syndrome or condition. Unlike idiopathic scoliosis, which has no known cause, syndromic scoliosis is directly associated with a specific underlying syndrome that often affects multiple systems in the body.

Scoliosis symptoms can vary depending on the severity of the spinal curve. In many cases, especially mild scoliosis, the symptoms may not be obvious. However, some common signs include:

• Uneven shoulders, waistline or hips.
• One shoulder blade may stick out more than the other.
• In more severe cases, the ribs may protrude on one side due to the twisting of the spine.
• A noticeable tilt of the body to one side.

Early diagnosis of scoliosis is key to effective management and treatment, minimising the likelihood of complications or the need for invasive procedures. If you notice any signs of scoliosis in your child, make an appointment with your GP.

Diagnosis typically involves a combination of physical exams, medical history, and imaging tests.

Physical Examination

• Adam’s Forward Bend Test: The child bends forward at the waist with arms hanging freely. The doctor looks for any unevenness in the ribs or back, which may indicate a spinal curve.
• Posture Assessment: The doctor examines the child’s shoulders, hips, and spine alignment to identify asymmetries.

Imaging Tests

If scoliosis is suspected during the physical exam, imaging tests (such as an X-Ray) are used to confirm the diagnosis and measure the curve.

When scoliosis is diagnosed, the main goal of treatment is to prevent the curvature from worsening and to address any potential impact on breathing, posture, or movement. Treatment options depend on factors like:

• The severity of the curve.
• The child’s age.
• Whether the curve is affecting the child’s overall health, such as their ability to breathe.

Treatment Options:

1. Observation: In mild cases, the doctor may recommend monitoring the curve through regular check-ups and imaging to see if it worsens.
2. Bracing or Casting: For moderate cases, a brace or cast may be used to guide the spine's growth and prevent the curve from increasing. This is most effective when the child is still growing.
3. Surgery: In severe cases, surgery may be necessary to correct the curve and stabilise the spine. Surgical options are carefully considered based on the child’s needs and overall health.