While most children first notice scoliosis or a curve in the spine when they are close to the teen years, there is another type of scoliosis called congenital scoliosis that affects newborn and very young children. These curves requires special attention as they have the potential to progress and to cause real problems for the child.
Congenital scoliosis usually means that there is either an extra part of the spine or two parts fused together which are contributing to the curvature. A pediatric orthopaedic surgeon can often predict the chance of progression based on the specific appearance of the curve.
It is also important to work closely with other specialists to ensure that there are no other related problems. Heart and kidney problems sometimes occur in infants with scoliosis and it is important to pay attention to this early.
Many of these curves can be observed and surgery can be avoided in many children. However, if the curve gets to a certain size or seems to be progressing too quickly, it may become necessary to do something to stop growth. Removal of the extra vertebrae, limited fusion, and use of a “growing rod” are the traditional surgical options in this area.
Sometimes the ribs of children with progressive early scoliosis become fused together thereby reducing the volume of the rib cage. In this condition, known as thoracic insufficiency syndrome, the limited chest volume interferes with lung growth, causing problems with breathing.
The titanium rib prosthesis is a revolutionary new type of treatment used to treat patients with thoracic insufficiency syndrome. The expandable prosthesis is implanted in a vertical position and attached to an upper and lower rib. The device helps maintain the chest space where there are fused or missing ribs, thus allowing room for heart and lung development. As the patient grows, the prosthesis is simply expanded through an outpatient surgical procedure.
While this procedure is new and only appropriate for a small number of children with scoliosis, it offers an exciting new option to children with congenital scoliosis.
Copyright © 2003, Michael Vitale, MD.
This information is the property of and has been provided by Michael Vitale, MD, Fellowship-trained Orthopaedic Surgeon