ROWAN BERKOWITZ BLOG

Understanding Early Onset Scoliosis: A Comprehensive Guide

Early-onset Scoliosis (EOS) is a medical condition affecting young children characterised by an abnormal sideways curvature of the spine. While not as common as Scoliosis diagnosed in adolescents, EOS requires prompt and effective management to prevent complications.

This guide covers the various aspects of EOS – its causes, symptoms, diagnosis, and potential treatment options.

What is Early Onset Scoliosis?

Defining EOS

Unlike Scoliosis, typically diagnosed between 10 and 18, EOS (Early-onset Scoliosis) refers to curvatures identified at a much younger age. It’s further categorised based on the age of diagnosis:

  • Congenital Scoliosis: Present at birth or shortly after.
  • Infantile Idiopathic Scoliosis: Diagnosed before age 3.
  • Juvenile Idiopathic Scoliosis: Diagnosed between ages 4 and 9.

Although it’s often detected as an adolescent, it may start its origin in a much younger child.

Understanding Severity of OES

The severity of Scoliosis is measured by the degree of the spinal curve. Here’s a general breakdown:

  • Mild Scoliosis: Curve less than 20 degrees.
  • Moderate Scoliosis: Curve between 25 and 40 degrees.
  • Severe Scoliosis: Curve exceeding 50 degrees.

What Causes Early Onset Scoliosis?

The exact cause of EOS can vary and, in some cases, may remain unknown. Here are some known contributing factors:

  • Congenital Issues: Sometimes, the vertebrae (spinal bones) don’t develop properly before birth, leading to curvatures.
  • Chest Wall Deformities: Conditions like pigeon breast (protruding breastbone) or fused ribs can be associated with EOS.
  • Underlying Medical Conditions: Neuromuscular disorders like spinal muscular atrophy (SMA) or neurofibromatosis (NF) can affect muscle control and development, impacting the spine’s alignment.
  • Idiopathic Causes: In many cases, no specific cause can be identified, which is called idiopathic EOS.

Symptoms to Watch For in EOS

Early detection is crucial for effective EOS management. While symptoms can vary, some common signs to be aware of include:

  • Uneven shoulder height or prominence of one shoulder blade.
  • Misaligned head position leaning towards one side.
  • Asymmetry in hip height or position.
  • Uneven rib cage on one side, especially when bending forward.
  • Variances in arm position or back appearance when bending forward.

Diagnosis: The First Step Towards Management

Diagnosis of EOS typically occurs during a routine paediatric check-up, and the process may involve:

  • A comprehensive physical examination to assess posture, alignment, and any visible signs of curvature.
  • Reviewing the child’s medical history, including a family history of Scoliosis.
  • Specific bone examinations like the Adam’s forward bend test to assess the curve’s prominence.
  • Measuring the Cobb angle using X-rays to determine the degree of curvature.
  • Advanced imaging techniques like MRI scans or ultrasounds can sometimes be needed for a more detailed evaluation.

Parents can also self-examine their children at home – read “How to examine your child for Scoliosis.”  

Treatment Options

The treatment approach for EOS is individualised based on several factors, including the severity of the curve, the child’s age and growth potential, and the specific type of EOS. Here’s an overview of potential treatment options:

  • Monitoring: Regular check-ups and X-rays to track the curve’s progression, especially for mild curvatures.
  • Bracing: Using custom-designed braces to help control the curve’s progression and improve spinal alignment.
  • Surgery: In severe cases where the curve is rapidly progressing or impacting lung function, surgery may be recommended to correct the curvature and prevent further complications. 

Goals of Treatment

The primary goals of EOS treatment are to:

  • Slow down or halt the progression of the spinal curvature.
  • Correct the curvature as much as possible while allowing for normal growth and development of the spine and chest.
  • Prevent or delay the need for surgery in the future.

Living with Early Onset Scoliosis

Early diagnosis and proper management are essential for children with EOS. With a comprehensive treatment plan and ongoing monitoring, most children with EOS can lead healthy and active lives. If you have any concerns about your child’s posture or spinal development, don’t hesitate to consult with a specialist for further evaluation.