Scoliosis Research Society (SRS)
An International Organization Dedicated to the Education, Research and Treatment of Spinal Deformity
Our Mission is to Foster Optimal Care for All Patients with Spinal Deformities
After the history and physical examination, the next step in evaluating congenital scoliosis is obtaining X-rays. Good quality anteroposterior (front-to-back) and lateral (from the side) X-rays are necessary. X-rays of the neck should be taken to look for abnormal vertebrae in this area. The three-dimensional structure of the congenital anomaly may be best seen on a CT scan with reconstruction (this study is usually done as part of a preoperative planning) (Figure 2). An MRI is very valuable to characterize the congenital anomaly and to be certain that there are no associated anomalies of the spinal cord. In children younger than 3 months (before the vertebrae ossify and harden), an ultrasound examination can scan the spinal cord for abnormalities without the need for sedation. Your spine surgeon may also advise your pediatrician to obtain an ultrasound of the kidneys or a cardiology (heart) consult. Because the kidneys and heart are formed at the same time as the vertebrae, something that affects the spine may likely affect the other organs. Children with congenital scoliosis have a 25% chance of having an anomaly in the urologic system (kidneys, bladder) or a 10% chance in the cardiac (heart) system. The child's limbs should be examined for any musculoskeletal abnormalities, such as a clubfoot or malformed hand/arm.
Figure 2: CT 3D reconstruction showing a T12 "butterfly" vertebra (cleaved in center) and right 3 hemi-vertebra.