INFANTILE AND JUVENILE SCOLIOSIS
Section snippets
Natural History and Epidemiology
Infantile idiopathic scoliosis is a structural spinal deformity detected during the first 3 years of life. It is slightly more common in Europe and accounts for fewer than 1% of all cases of idiopathic scoliosis in the United States.21 The prompt recognition of infantile scoliosis is critical and is the responsibility of parents and pediatricians. Early orthopedic referral is mandatory because early treatment can affect the outcome.40
Infantile scoliosis is unique in many ways. It is more
Natural History and Epidemiology
Juvenile idiopathic scoliosis is defined by detection of the scoliosis deformity in patients between 4 and 10 years of age; it represents 12% to 21% of patients with idiopathic scoliosis.48 The cause remains unknown and may differ depending on age of presentation. Because juvenile and adolescent scoliosis appear to be more closely related to each other than to infantile scoliosis, theories regarding the cause of adolescent scoliosis also may be applicable to juvenile scoliosis. There are a
SURGICAL TREATMENT OPTIONS FOR BOTH INFANTILE AND JUVENILE SCOLIOSIS
The type of surgery performed depends on the age of the child at the time the curve is progressing. The amount of spinal growth remaining is the chief consideration. It has been shown that curve progression and increased curve rotation occur with posterior fusion alone.17, 39, 54 In young patients after a posterior fusion, anterior spinal growth continues, which causes an increase in vertebral body height. In addition, the vertebral bodies rotate on the posterior fusion, causing an increase in
SUMMARY
The diagnosis and treatment of scoliosis in the growing child is a challenging endeavor. It is crucial that the correct diagnosis be established initially. Early referral and treatment is imperative. Careful follow-up is mandatory. If a deformity is proved to be progressive despite bracing, surgical intervention is likely to be necessary. Because significant truncal shortening is an issue with early spinal fusion, a young child may benefit from instrumentation without fusion. Ultimately,
References (63)
Cardiorespiratory consequences of unfused idiopathic scoliosis
Br J Dis Chest
(1986)Dogma disputed: The aetiology of spinal deformities
Lancet
(1988)Infantile and juvenile idiopathic scoliosis
Orthop Clin North Am
(1988)- et al.
Adolescent idiopathic scoliosis: Nonoperative treatment
Orthop Clin North Am
(1988) - et al.
Progressive scoliosis as the first presenting sign of syringomyelia: Report of a case
J Bone Joint Surg Br
(1983) - et al.
Vibratory hypersensitivity in idiopathic scoliosis
J Pediatr Orthop
(1988) - et al.
Moe's Textbook of Scoliosis and Other Spinal Deformities
(1978) Congenital postural scoliosis
Proc R Soc Med
(1956)- et al.
Prognosis in infantile idiopathic scoliosis
J Bone Joint Surg Am
(1980) - et al.
Intramedullary spinal cord tumours presenting as scoliosis
J Bone Joint Surg Br
(1984)
Outline for the study of scoliosis
AAOS Instr Course Lect
Juvenile idiopathic scoliosis
Semin Spine Surg
Surgical treatment of late onset idiopathic thoracic scoliosis: The Leeds precedure
J Bone Joint Surg Br
The pathogenesis of idiopathic scoliosis: Biplanar spinal asymmetry
J Bone Joint Surg Br
Syringomyelia and Chiari I malformation presenting with juvenile scoliosis as the sole manifestation
J Spinal Disord
Progressive and resolving infantile idiopathic scoliosis—differential diagnosis
J Bone Joint Surg Br
Juvenile idiopathic scoliosis
J Bone Joint Surg Br
Incidence of neural axis abnormalities in infantile and juvenile patients with spinal deformity
Is a magnetic resonance image screening necessary? Spine
The effect of the adolescent growth spurt on early posterior spinal fusion in infantile and juvenile idiopathic scoliosis
J Bone Joint Surg Br
Two curve patterns in idiopathic structural scoliosis
J Bone Joint Surg Br
The prognosis, diagnosis, and operative indications related to curve patterns and the age at onset
J Bone Joint Surg Br
Infantile idiopathic scoliosis
Clin Orthop
Patterns in idiopathic structural scoliosis
J Bone Joint Surg Br
The part-time Milwaukee brace treatment of juvenile idiopathic scoliosis: Long-term follow-up
Clin Orthop
Fusion of the scoliotic spine in young children: Effect on prognosis and growth
Clin Orthop
Routine use of magnetic resonance imaging in idiopathic scoliosis patients less than eleven years of age
Spine
Structural idiopathic scoliosis in infancy: A study of the natural history of 100 patients
J Bone Joint Surg Br
Embryology and growth.
Scoliosis.
Paralytic scoliosis in growing children
Clin Orthop
Treatment of scoliosis without arthrodesis or external support: A preliminary report
Orthop Trans
Cited by (0)
Address reprint requests to Stuart L. Weinstein, MD, Department of Orthopaedic Surgery, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52242
- *
Department of Orthopaedic Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa