Congenital Scoliosis

Congenital scoliosis is a type of spinal deformity caused by an abnormal development in the structure of the spine. The abnormality, which causes the spine to develop a scoliosis, exists at birth but may not be noticed until an abnormal spine curvature develops with time. Some of these deformities are mild and may require no treatment while others run the risk of developing very severe spinal curvatures with growth. The key is to properly detect the spinal abnormality early on so that treatment (if necessary) can be considered immediately. Congenital scoliosis can be associated with other abnormalities in the internal organs (most commonly the heart and kidneys).

The abnormality in congenital scoliosis can involve either a failure of a portion of the spine to form normally (called a failure of formation), or a failure of parts of the spine to separate during development (called failure of segmentation). Thus the spine begins to grow in a crooked manner and as the patient grows in height this curvature becomes more and more apparent.

Prior to developing a treatment plan it is essential to pursue a complete evaluation for any abnormalities in the brain or spinal cord as well as any other organ malformations (commonly heart, kidneys). Depending upon the type and severity of the spinal anomaly, the treatment may range from observation (no immediate intervention, but close follow up with a specialist) to surgery. Brace wear is rarely effective for these types of scolioses.

If a scoliosis due to a congenital problem is severe or progressing rapidly then surgery may be a good option to consider. In the past there were concerns over a loss in spinal growth after surgery to treat a congenital problem. While this may occur, the other thing to consider is that leaving a congenital problem which is causing severe spinal deformity may make later surgery more involved, more difficult and with less chance at obtaining a well balanced spine.

Some of the common surgical techniques which are considered in treatment of a significant congenital problem include: a short fusion of the abnormal region of the spine, a removal of the abnormal vertebral elements, a partial fusion of an area where abnormal growth is occurring.

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