Related Health Information
Congenital Scoliosis
Congenital (at birth) scoliosis is not as common as the idiopathic type (scoliosis with no known cause). Congenital scoliosis is caused by:
- Incomplete formation of one or more of the vertebral bodies
- Fusion that binds two or more vertebral bodies together
When the vertebra doesn't form properly, a hemivertebra or wedge-shaped vertebra develops. When a fusion occurs, the spine is tethered on one side. In both cases, growth is uneven -- growth on one side of the spine is slower than on the opposite side of the spine. This causes a progressive curving of the spine as it grows. In time, the deformity can become rigid and severe.
Other defects that may occur
At the time that congenital scoliosis is developing, other organs may not be developing correctly, particularly the kidneys, heart and spinal cord. Some of these problems may not be initially obvious, so a diagnosis of congenital scoliosis also requires a search for other problems. Orthopaedic surgeons at The Children's Hospital of Philadelphia work with other experts at Children's Hospital to provide full diagnosis, evaluation and treatment of any of these additional conditions.
Treatment options
A congenital scoliosis deformity usually becomes obvious as your child grows and the deformity progresses or worsens. In order to treat congenital scoliosis, we focus on:
- Preventing the curve from progressing to a severe deformity
- Providing spinal balance
Usually curve progression can be prevented by spinal fusion surgery: either posterior spinal arthrodesis or anterior spinal arthrodesis or both. Spinal balance can be achieved with a skilled brace treatment or a gentle instrumentation during the arthrodesis surgery. Because of the risks associated with the anterior arthrodesis, so we advise neurophysiological monitoring of the spinal cord function during the procedure.
Less commonly, we may advise a more aggressive reconstructive approach such as removing a vertebra to correct the spinal imbalance associated with a more severe spinal deformity.
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