Infantile Scoliosis and bracing

Each year around 100,000 kids in the US are diagnosed with Idiopathic Scoliosis.  Most of these children will be between the ages of 10-15.  There are, however, kids younger than this that develop Idiopathic scoliosis as well.  This type of scoliosis is termed Early Onset Scoliosis (EOS) and encompasses kids ages infant to 8 years old.  EOS can be divided into two more classes which are Infantile Scoliosis (ages 0-3)  and Juvenile Scoliosis (ages 3-8).  Within EOS infantile scoliosis (IS) is rare and is again divided into 2 categories, which are progressive and non-progressive.  Studies show that most cases of IS will affect boys, 90% of the cases of IS will self correct by age 3 or be non-progressive and 10% will progress.  Infantile scoliosis has no known cause but typically occurs with other developmental problems including bone deformities, neurological issues and in some cases pathological problems.  So a thorough exam, including physical observation, neurological testing and advanced diagnostic imaging, needs to be performed.

Early X-ray imaging in IS can help to determine if progression is imminent.  There are unique X-ray findings between the vertebra in the spine and the angle of the ribs called the Rib Vertebral Angles (RVA) that need to be measured and monitored over a 3 month period to determine if the chance for progression is high or not.  If these RVA angles worsen over 3 months ,and progression is assured in 80% of these cases, then treatment must be started ASAP to ensure the best chance of a positive outcome.

Typical treatment for IS is serial casting.  This procedure in most cases involves sedating the infant and then using a device to stretch, bend and rotate the infants spine to a straight presentation and then applying a body cast to the infant to hold them in the corrected position.  This procedure is effective but there are downsides because  these casts have to be changed out with frequency, so the infant is sedated each time.  Cleanliness is also an issue as the child is wrapped in a cast hence bathing and going to the bathroom are a problem.

Our facility can offer an alternative to serial casting using the rigid Scolibrace.  The Scolibrace works on the same principles as casting, however, the child is not stretched on a device,  the brace can be removed to allow the child to be bathed and cleaned after going to the bathroom and the child does not have to be sedated to go through the bracing process.  Like the casts the Infantile scolibrace does need to be changed out to accommodate the rapid growth in the first 2 years, but the change is less frequent than the casts due to the cleanliness issues.  Progressive IS typically produces large curves and in some cases Serial Casting is the best option and we will tell our patients that, but curves 40 degrees and below can be successfully treated with the Infantile Scolibrace.  In any of these cases we will also consult with the Pediatric Orthopedist to ensure that their opinion is heard on bracing as well.

If you are your child is dealing with Scoliosis we would be glad to consult with you regarding the treatment options we provide.  Call us at (480) 892-0022.