Scoliosis is a traumatic, idiopathic, prenatal, or S-shaped lateral curvature of the spine that can develop as a result of certain neuromuscular diseases. The patient can be diagnosed with scoliosis when these curvatures are greater than 10 degrees.
What is Congenital Scoliosis?
Scoliosis, which has different types based on its origins, is called congenital scoliosis if it developed before birth, that is, while the baby was still in the womb.
Unlike idiopathic scoliosis, which is the most common type of scoliosis, congenital scoliosis usually does not respond to brace treatment and can be detected during postnatal controls. Since the baby has just started to develop, treatment can be started immediately.
What causes congenital scoliosis?
In the womb, the spine is first formed to resemble a tube. Later, this tubular structure divides to form vertebrae and the intervertebral discs between them. Congenital scoliosis is a type of scoliosis that results from abnormalities that occur during the formation of the baby’s spine in the womb. These abnormalities that occur during the development of the baby’s spine in the womb lead to congenital scoliosis. This condition, which can be related to the differentiation or formation of vertebrae during development, can be classified in 2 different ways:
Formation problems;
Under normal circumstances, a standard vertebra resembles a rectangle. If, for some reason, the baby’s vertebrae are not fully formed in the womb and develop in a triangular shape, this can lead to congenital scoliosis. In such a case, the muscles that develop according to the standard shape of the spine put more pressure on one part of the body, triggering the development of scoliosis.
Separation problems;
Separation problems are when one or more vertebrae, which should be separated during spinal development and have discs between them, remain stuck together in one area. The vertebrae that cannot continue to grow from the adherent part grow from the free part, and the curvature reoccurs.
In some cases, congenital scoliosis can occur in more than one vertebra. In rare cases, it is even possible to see more than one type in more than one vertebra.
Symptoms of Congenital Scoliosis
Although congenital scoliosis is often diagnosed during postnatal check-ups, it can sometimes present itself later in the baby’s development. Early diagnosis is important as it progresses rapidly and certain symptoms of congenital scoliosis are as follows:
- Uneven shoulders
- One hip is significantly lower or higher than the other
- Instability of the shoulder blades in the forward bending position
- Short or stiff neck
- Lack or adhesion of the ribsHair and/or dimples on the back
- Hunchback or lumps on the back
- Heart, kidney, intestine, esophagus etc. organ problems
Congenital Scoliosis Treatment
Because congenital scoliosis progresses rapidly and is usually detected at an early age, the treatment process differs from that for idiopathic scoliosis. In the treatment of congenital scoliosis, age, type of deformity, and the rate of growth of the curve are the most important factors. While the patient’s age determines the choice of surgical or non-surgical treatment, the child’s development also plays a role. Whether or not lung and chest development is complete changes the type of surgical method. In addition, scoliosis can grow rapidly during periods of rapid growth, such as 5 years of age and adolescence.
The type of deformity will change the type of surgical procedure to be performed. In addition, because the problem in congenital scoliosis is the bone itself and the problem area does not move much anyway, the response rate to brace and scoliosis physical therapy exercises is generally low. However, a brace can be applied to the balancing curves formed at the top and bottom of the curves to stop the progression of these curves.
Although scoliosis does not show progression at a young age, its potential rate of progression is another factor that determines the treatment process. During periods of rapid growth, scolioses that previously did not show growth may show rapid growth.
Congenital Scoliosis Surgery
As mentioned above, treatment depends on the type of deformity and the age of the patient. When the patient reaches the appropriate age, several surgical treatment options are available. If the child is still developing, it is possible to treat with expandable rods so as not to interfere with breast development. Since the rods are enlarged at the appropriate growth stages, they do not pose a developmental problem.
Another method is to remove the underdeveloped vertebra and replace it with a supportive material. This largely corrects the imbalance in the development of the vertebrae and the scoliosis caused by the imbalance. The same procedure can be applied to adherent vertebrae. The goal of all of these procedures is to correct the curve in the spine and to ensure that the muscles around the spine apply equal force to each area.
