Idiopathic Scoliosis

Infantile

Treatment

When scoliosis occurs at a very young age, there are several important implications for management and treatment. For example, a 60^o idiopathic curve (cause of scoliosis unknown) in a teenager is typically managed quite successfully with a posterior instrumented fusion. The same 60^o curve in a 2-year old is managed very differently. The 2-year old needs many years to maximize their trunk height and lung size. A fusion in a young child would prevent further growth of the instrumented segment. Furthermore, depending on the type of instrumentation used, the anterior spine may continue to grow leading to “crankshaft phenomenon”. In this situation, the scoliosis continues to progress despite the posterior fusion. For this reason, other treatments have been developed for the management of early onset scoliosis. These techniques take into account the growth of the spine as well as the growth of the rib cage and lungs. If implants are necessary, multiple expansions or lengthenings may be necessary (usually twice per year) to keep up with growth in the young spine.

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