Pediatric Congenital Scoliosis
When the spine is twisted or rotated at birth, it is called congenital scoliosis.
Scoliosis is defined by an abnormal curvature of the spine. When this spinal deformity is present at birth, it is called congenital scoliosis. Congenital scoliosis is not as common as other types of scoliosis, like idiopathic adolescent scoliosis or early onset scoliosis, that begin during growth.
Congenital scoliosis is marked by a spine that is twisted or rotated to one side. In severe cases, the rib cage is also pulled to the side.
The two main causes of congenital scoliosis are an incomplete formation of the vertebrae and failure of the vertebrae to separate during fetal development.
- Incomplete formation of vertebrae — This happens when one or more parts of the vertebrae do not completely form during normal fetal development. An abnormally shaped, incomplete vertebra can produce a sharp angle in the spine, called a hemivertebra, which may increase as the child grows. If the child has more than one hemivertebra, it is possible that they will balance each other out, causing the spine to be more stable and symptoms to be less severe.
- Failure of the vertebrae to separate — When the vertebrae fail to separate as part of normal fetal development, it can cause the formation of a bony bar where two or more vertebrae join. The bony bar prevents the spine from growing at a normal rate on one side after birth, causing the spine to curve more as the child grows. In some cases, a child may have both — a hemivertebra on one side of the spine and a bony bar on the other, which causes a severe growth problem from an early age. In addition, when a child has congenital scoliosis, their spine may develop other curves in the opposite direction to help them maintain an upright position.
It may be obvious that a child has congenital scoliosis from birth, or signs may not appear until later during growth.
Physical symptoms of congenital scoliosis may include:
- Appearance of leaning to one side
- One hip that sits higher than the other
- Protruding shoulder blade on one side
- Ribs sticking out more on one side
- Weakness or numbness in the limbs due to spinal cord compression (rarer)