Causes and treatment of scoliosis in infants

If babies develop scoliosis, it is usually due to congenital causes. Because they are still young and their bones are not fully developed, this phenomenon must have occurred at birth. Surgery cannot be performed now because they are still too young and cannot withstand surgery. So what exactly causes scoliosis in babies and how should it be treated?

Congenital scoliosis or kyphosis usually refers to spinal deformity caused by abnormal structure of the vertebrae themselves. Its pathological structural types are usually divided into incomplete vertebral scoliosis bone formation or incomplete separation.

The most prominent feature of vertebral agenesis is that the intervertebral space usually exists normally, but the pedicle on one side of the vertebra is underdeveloped or disappears, or it fuses with the adjacent vertebra, or X-rays show that the distance between the vertebral intervertebral space is widened; the most prominent feature of vertebral septum incompleteness is that the intervertebral space between two vertebrae (or even multiple vertebrae) disappears, and while the vertebrae fuse into a whole, the pedicle on one side disappears, and even a bony connection (bone bar) is formed. The opposite side may have hemivertebrae with intervertebral disc development. This can occur in the coronal or sagittal plane, resulting in either scoliosis or kyphosis.

Congenital spinal malformations are usually accompanied by spinal cord malformations, such as intraspinal tumors, diastematomyelia (5-21%), intraspinal bony (membranous) mediastinum formation, tethered cord, low-positioned cone medulla, syringomyelia, meningocele, etc. At the same time, benign tumors such as epidermoid cysts, dermoid cysts, teratomas, etc. may also occur in the spinal canal. The cause of this concomitant spinal cord and spinal column deformity is due to abnormal development of the notochord and spinal cord segments formed during embryonic development (the first 6 weeks of embryonic development). Clinical manifestations may include lumbar sinus tracts, increased hair growth, local protrusions, and subcutaneous lipomas.

Congenital spinal malformations are usually accompanied by developmental malformations of other organs, which can be abbreviated as VACTERL, that is, V-vertebral malformation, A-anal atresia, C-cardiovascular malformation, TE-tracheoesophageal fistula, R-renal dysplasia, and L-limb dysplasia. It may also be accompanied by scapular winging, Klippel-Feil syndrome and other lesions.

The treatment of congenital scoliosis is divided into observation and surgical treatment. Brace treatment is ineffective for this type of patient because the brace correction force cannot correct the congenital deformity of the vertebrae. If the patient has no obvious abnormalities in appearance, such as asymmetry of the shoulder and hips, deformity of the back, and does not feel any discomfort, continued observation for about 4-6 months can be considered; otherwise, surgical treatment can be considered. Different surgical methods can be selected according to different ages, locations of deformities and overall balance. Such as hemivertebra epiphysis fusion, hemivertebra resection, scoliosis in situ fusion, etc. Currently, with the improvement of surgical instruments and concepts, the treatment of congenital hemivertebra mainly considers hemivertebra resection, internal fixation and corrective fusion surgery. Congenital scoliosis can cause progressive deformity at any age.

The above article introduces in detail the causes and treatments of infant scoliosis. In fact, pregnant women should do this kind of examination at the beginning of pregnancy to avoid scoliosis in their babies. If it really happens, it must be corrected in time.