Early Onset Scoliosis

Early onset scoliosis (EOS) refers to the development of abnormal lateral curvature of the spine before the age of 10. This condition can be congenital or acquired and poses unique challenges because the spine is still growing rapidly during this period. Early onset scoliosis can have various causes, and treatment approaches aim to manage the curvature while allowing for continued spinal growth. Here are key points about early onset scoliosis:

  • Causes:
    • Congenital: Abnormal spine development present at birth.
    • Neuromuscular: Resulting from neuromuscular conditions affecting muscle and nerve function.
    • Idiopathic: Without an apparent cause, similar to adolescent idiopathic scoliosis but occurring at a younger age.
    • Syndromic: Associated with genetic syndromes or other systemic disorders.
  • Diagnosis:
    • Typically diagnosed through physical examination, imaging studies (X-rays, CT scans, or MRIs), and sometimes genetic testing.
    • Early detection is crucial to initiate timely intervention.
  • Treatment Options:
    • Observation: In mild cases, especially if the curvature is not rapidly progressing, regular monitoring may be recommended.
    • Bracing: Customized braces may be used to slow down the progression of the curvature, allowing for continued growth.
    • Casting: Serial casting involves applying and changing casts regularly to gently guide the spine into a straighter position.
    • Growth-Friendly Devices: Implanted devices like growing rods or Vertical Expandable Prosthetic Titanium Ribs (VEPTR) are used to control the curvature while allowing for spinal growth.
    • Tethering: A surgical technique that involves placing a flexible cord along the concave side of the spine to partially restrict its growth while allowing for controlled growth on the convex side.
    • Vertebral Body Stapling: A minimally invasive procedure involving the placement of staples across the growth plates to modify spinal growth.
  • Surgical Intervention:
    • Surgical options may be considered if the curvature is severe, rapidly progressing, or not responding to non-surgical measures.
    • Spinal Fusion: A procedure involving the fusion of vertebrae to correct the curvature and stabilize the spine.
  • Multidisciplinary Approach:
    • Management of early onset scoliosis often requires a multidisciplinary team, including orthopedic surgeons, pediatricians, physical therapists, and other specialists.

The choice of treatment depends on factors such as the cause of scoliosis, the degree of curvature, and the age of the child. The goal is to control the curvature while allowing for normal growth and development. Regular follow-up and monitoring are crucial to assess progression and adjust the treatment plan as needed.

Magnetic Resonance Imaging (MRI) is a non-invasive medical imaging technique that uses a strong magnetic field and radio waves to create detailed images of the internal structures of the body. During an MRI scan, the patient lies within a large magnet, and radiofrequency pulses are applied, causing the body’s hydrogen atoms to emit signals that are detected by the MRI machine. These signals are then translated into high-resolution, cross-sectional images, providing clear visualization of soft tissues, organs, and structures such as the brain, spinal cord, joints, and muscles. Unlike X-rays or CT scans, MRI does not use ionizing radiation, making it a safe and valuable tool for diagnosing various medical conditions and guiding treatment decisions. The versatility of MRI makes it particularly effective in capturing detailed images of both anatomical structures and pathological changes within the body.

Mehta casting, developed by Dr. Min Mehta, is a non-surgical method addressing early onset scoliosis in infants and young children. Administered under general anesthesia, the technique involves applying strategically molded fiberglass or plaster casts to redirect spinal growth and correct curvature. Initiated before age three during the rapid growth phase, Mehta casting requires multiple cast changes over time. While most effective for specific early onset scoliosis types, it may not suit all cases or older children. Successful outcomes yield significant spinal correction, contributing to normal growth. Mehta casting is a key element in a comprehensive treatment approach, often complemented by follow-up interventions, such as bracing or surgery, tailored to individual conditions. Regular monitoring and collaboration with a multidisciplinary healthcare team are vital for treatment success.

Scoliosis bracing is a non-surgical strategy to impede or slow down the advancement of spinal curvature, mainly applied in cases of adolescent idiopathic scoliosis. Constructed from rigid plastic, the custom-fitted brace aims to apply corrective pressure to the spine and is worn for most waking hours. Its effectiveness relies on the patient’s adherence to usage. Typically recommended for moderate curves, the specific design and duration of wear are tailored to the severity of the curvature and the patient’s growth stage. Consistent monitoring and periodic adjustments are crucial aspects of scoliosis bracing to enhance its effectiveness in optimizing spinal alignment.

Growing rods are surgically implanted in the treatment of early onset scoliosis, especially in growing children. These adjustable rods support spinal growth while simultaneously correcting and controlling curvature. In contrast to traditional spinal fusion, growing rods facilitate continued spinal growth by periodic lengthening as the child develops. This approach effectively manages progressive scoliosis in young patients, allowing controlled correction without hindering spine development. Follow-up surgeries are required to extend the rods until the child reaches skeletal maturity. A final fusion procedure may be considered for long-term stability, making growing rods a dynamic and growth-friendly solution for pediatric scoliosis treatment.

MAGEC rods, or Magnetic Expansion Control rods, are spinal implants utilized in the treatment of early onset scoliosis. These rods are magnetically controlled, allowing non-invasive lengthening and reducing the need for frequent surgeries. Surgically implanted, MAGEC rods enable adjustments to accommodate a child’s growth and correct spinal curvature without invasive procedures. The external lengthening process, facilitated by a remote control device, minimizes the impact on the child’s daily life. MAGEC rods present a dynamic and less invasive option compared to traditional growing rods, providing continuous spinal support while minimizing the number of required adjustment surgeries. Regular follow-up appointments are crucial for monitoring and managing the lengthening process based on the child’s growth.