Early Onset Scoliosis | Scoliosis Research Society
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Early Onset Scoliosis

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Early Onset Scoliosis refers to spine curvature that is present before 10 years of age.

Different causes:

  • Idiopathic - Curves for which there is no apparent cause.
  • Congenital - Vertebrae develop incorrectly inutero. It is sometimes associated with cardiac and renal abnormalities. Evaluation may include studies of heart and kidneys.
  • Neuromuscular - In children with neuromuscular disorders including spinal muscular atrophy, cerebral palsy, spina bifida and brain or spinal cord injury.
  • Syndromic - Certain syndromes, such as Marfans, Ehlers-Danlos and other connective tissue disorders, as well as neurofibromatosis, Prader-Willi, and many bone dysplasias may be associated with EOS.


EOS, depending on the severity, may be associated with heart and lung problems in childhood which may become increasingly problematic in adult years. When untreated, severe EOS may be associated with an increased risk of early death due to heart and lung disease. Prognosis will also depend on any underlying disorders or comorbidities. Thoracic Insufficiency Syndrome (TIS) is commonly used to describe the potential combined spine and lung problems in EOS.

  • Likely to progress: Idiopathic EOS with curves greater than 30-35 degrees
  • Likely to resolve without treatment: Children younger than age 2 with infantile idiopathic curves less than 35 degrees


  • Plain X-rays are sufficient to make the diagnosis of EOS.
  • MRI may be indicated for certain patients with EOS.
  • CT best helps visualize bone anatomy in congenital scoliosis, and is often useful for surgical planning, but must be weighed against risk of radiation to a young child.

Treatment Goals:

  • Minimize spinal curvature over the life of the patient.
  • Maximize lung function over the life of the patient.
  • Minimize the extent of any final spinal fusion.
  • Maximize motion of chest and spine.
  • Minimize complications, procedures, hospitalizations and burden for the family.
  • Consider overall development of the child.




The behavior of the curve may be monitored via repeated clinic visits and x-ray examinations at various times during development for worsening or progression of the scoliosis. 

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Bracing or casting programs may help by allowing growth while minimizing increases in the scoliosis. The need for surgery may be delayed and, in some instances, avoided. 

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Surgery is generally recommended if brace or cast treatment should fail to keep the scoliosis from progressing, or if the curve pattern does not appear amenable to brace or cast treatment.

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Frequently Asked Questions

Early Onset Scoliosis Frequently Asked Questions

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Is all EOS the same?

No, there are several types of EOS: some is caused by misshaped bones (vertebra) in the spine, this is called congenital 3 , 4 , 5 ; some patients have a neuromuscular disease like muscular dystrophy where the muscles can not hold the spine straight 6 ; other patients have a diagnosed syndrome (a disease with effects on more than one part of the body) that causes scoliosis; and a very small number of patients have EOS with no identified reason and are called idiopathic 1

Is scoliosis passed on to the child by parents or relatives?

A small number of patients have genetic or inherited EOS (idiopathic, some syndromes), meaning one or both parents had a gene causing scoliosis that is present in their child. If this is true for your family your doctor will inform you of the details and you may be referred to a doctor who specializes in genetics.

What Causes EOS?

Most types of EOS have a known cause (misshaped bones in the spine, or muscular problems such as muscular dystrophy), however some types of scoliosis have no clear cause and are diagnosed as idiopathic (meaning we do not know what the cause is). Not drinking enough milk or wearing a heavy backpack does not cause EOS.

How is EOS noticed in most children?

You or someone else may notice your child’s back is curved. Some children with EOS have uneven waists, shoulders and/or shoulder blades, and a “hump” where the ribs stick out more on one side than the other. 7 , 8 . Sometimes the scoliosis is noticed when a child goes to the doctor for something else (like pneumonia or RSV) and an x-ray of the chest is done.

What are the treatment options for EOS?

There is a wide range of treatments for EOS, and each patient’s treatment is unique to the child and their doctor. Some patients may only need to be checked during times when the child is rapidly growing. Patients with small to moderate size curves may wear a plastic body brace. Young patients with flexible curves may be put into a series of molded plaster casts. Braces and casts are normally used to prevent the curve from getting worse and are very effective in some patients. Patients with more severe curves may require surgical correction of their scoliosis. There are several surgical options that allow the spine to grow while controlling the curve; these options include Traditional Growing Rods (TGR), Magnetically Controlled Growing Rods (MAGEC™), Vertical Expandable Prosthetic Titanium Rib (VEPTR®), Growth Guided Devices (Shilla® or Luque Trolley), Tension-based device (Tether or Staples) or a spinal fusion. Some patients may need to be treated with halo gravity traction in preparation for their surgery.

Will the brace “cure” the scoliosis?

A brace will not correct or cure scoliosis. When worn most of a 24-hour day a brace can slow down the growth of a curve. The purpose of a brace is to prevent scoliosis from rapidly worsening in a patient and delaying, or at best, avoiding surgery.

What if my child can’t or won’t wear the brace?

It is very important that if your child is not wearing the brace for more than a few days that you contact your doctor and let them know. It can take some time to get used to the brace, your doctor and the person who made the brace can help with this. Your child’s doctor understands the challenge of brace wear in this age group; you should be able to discuss these challenges with them openly.