CONGENITAL SCOLIOSIS

Congenital Scoliosis

As a result of research, it has been found that Congenital scoliosis occurs in only 1 in 10,000 newborns.  Of those affected, the majority are male.  This condition is much less common than idiopathic scoliosis, which usually becomes evident in adolescence.

What is Congenital Scoliosis?

With congenital scoliosis, the following may occur during the baby’s development in the womb:

• The bones (vertebrae) in the spine may not form normally
• One or more bones in the spine may be absent
• Bones may partially form
• Bones may not be separated as they should be

In addition to scoliosis curves, a child’s spine may also develop other curves in the opposite direction — above or below the affected area — to compensate and maintain an upright posture.  At Southwest Scoliosis Institute, each patient and parent of the patient becomes well informed of all the options available. 

We not only treat the patient, but we work with the entire family.

Also, our doctors outline all options and every effort is made to take the most conservative route possible. “Firstly, I involve my patients and their families in the decision-making for their child’s treatment, carefully tailoring the management to their medical & social needs and constraints.  In addition, I believe in an informed patient and family, treating every child as I would my own.” Dr. Shyam Kishan

Symptoms 

• Tilted, uneven shoulders, with one shoulder blade protruding more than the other
• A rotation of the neck causing the head to tilt in one direction
• The prominence of the ribs on one side
• Uneven waistline
• One hip higher than the other
• An overall appearance of leaning to the side
• A problem with the spinal cord or nerves that produce weakness, numbness or a loss of coordination in rare cases

Diagnosing Congenital Scoliosis

Young boy in EOS X-Ray

In order to diagnose congenital scoliosis, the doctors at Southwest Scoliosis Institute will look carefully at the child’s medical history and perform a thorough physical examination. Furthermore, the doctors will also order an X-ray to get a detailed view of the spine.  At our Dallas offices, we have the latest technology, a 3D low radiation EOS X-ray.

In addition, the doctor may order further tests (such as an MRI, or ultrasound) to see if there are any issues with the spinal cord itself, as well as any nerves surrounding the affected part of the spine.

Treatment 

For curves less than 25 degrees, we recommend ongoing monitoring by our orthopedic physicians, Richard Hostin, MD, Devesh Ramnath, MD, Ishaq Y. Syed, MD, Shyam Kishan, MD, and Kathryn Wiesman, MD. If they find that the child’s spinal curves are worsening, the doctors may suggest spine bracing. “Because bracing reduces the pressure on your child’s lower back, bracing helps straighten your child’s spine.  Thus, the ultimate treatment goal is to prevent the curve from progressing,” states Dr. Hostin.

For children with curves between 25 and 40 degrees, the recommended treatment will depend on your child’s individual circumstances. “For example, either spine bracing or spinal surgery may be the appropriate treatment for your child,” explains Dr. Kishan.

Because of further suspicions, our doctors may order further tests. These tests may include an MRI or ultrasound scans to view the spinal cord. The doctor will be able to view nerves surrounding the affected part of the spine as well.

Congenital Scoliosis Surgery

For congenital scoliosis, the most common surgical treatments are implanting growing rods and spinal fusion. However, the determination of which surgery is right for your child will depend on your child’s age and skeletal maturity, along with a host of other medical considerations.  Above all, our Scoliosis Doctors will take the time to review all the options with you so you can make an informed decision.

“Because It’s a serious surgery, it’s critically important that we sit down with patients and their families to explain the risks and benefits of each procedure,” Dr. Hostin explains. “Furthermore, I spend significant time in preoperative conversations discussing the risks, the benefits, the possibilities, and what my own personal experience has been over the last 15 years.  Therefore, my goal is to make sure the individual or parent who opts for surgery has a complete understanding of the risks and the intended outcome.”

Finally, if your child has other health issues — such as heart, lung, or kidney problems — our orthopedic team works with experts in these disciplines to ensure your child gets the comprehensive care they need.