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
Just as described for infantile scoliosis, your pediatric spine surgeon may choose to order an MRI. This decision is based on the presentation of the curve, findings on physical examination, and radiographic features. As a rule of thumb, approximately 20% of children who are younger than 10 and who have a curve greater than 20? will have an underlying spinal condition. There is a particularly high incidence of Arnold-Chiari malformation (in which the brainstem is lower than normal) and syringomyelia (cyst in the spinal cord) associated with curves under 10 yoa, which might be detected on an MRI of the entire spine. (Figure 1) If something is seen on the MRI that could be causing your child's scoliosis, your doctor will probably refer you to a pediatric neurosurgeon and the condition will be reclassified as a neuromuscular scoliosis. On occasion, a neurosurgical intervention may help correct the neuromuscular curvature.
Juvenile curves that reach 30o tend to continue to worsen without treatment. Bracing is often used to manage these curves, but nearly 95% of children in the juvenile age range go on to require surgical treatment.