Scoliosis Research Society (SRS)
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
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Juvenile Scoliosis

Side-view MRI showing syrinx (abnormal collection of fluid within the spinal cord) in a 7-year-old boy with a 30<sup>o</sup> neuromuscular scoliosis.
Figure 1: Side-view MRI
showing syrinx (abnormal
collection of fluid within
the spinal cord) in a
7-year-old boy with a 30o
neuromuscular scoliosis.
Juvenile idiopathic scoliosis is classically defined as scoliosis that is first diagnosed between the ages of 4 and 10. This category comprises about 10% to 15% of all idiopathic scoliosis in children. At the younger end of the spectrum, boys are affected slightly more than girls and the curve is often left-sided. Towards the upper end of the age spectrum, the condition is more like adolescent idiopathic scoliosis, with a predominance of girls and right-sided curves.

Evaluation
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.

Prognosis
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.