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The management of infants with scoliosis
Insights
Early and consistent treatment of infantile scoliosis, including progressive idiopathic scoliosis and congenital scoliosis, can effectively control curve progression. This approach offers a positive outlook for severe pediatric spinal conditions.
Area of Science:
- Pediatric Orthopedics
- Spinal Deformity Research
- Developmental Pediatrics
Background:
- Infantile scoliosis, encompassing progressive infantile idiopathic scoliosis and congenital scoliosis, presents a high risk of inevitable early and damaging deterioration.
- Early intervention is crucial for managing severe spinal deformities in infants.
Purpose of the Study:
- To evaluate the long-term efficacy of early and aggressive treatment for severe infantile scoliosis.
- To assess the outcomes of treatment protocols involving plaster casts, bracing, and surgical correction in children with progressive infantile idiopathic scoliosis and congenital scoliosis.
Main Methods:
- A cohort of twelve infants diagnosed with either progressive infantile idiopathic scoliosis or congenital scoliosis was treated from before age three.
- Treatment involved initial plaster casting, followed by a Milwaukee brace, and surgical correction and fusion around age ten.
- Patients were monitored until skeletal maturity.
Main Results:
- Out of twelve cases, only one showed curve progression (16 degrees) from infancy to skeletal maturity.
- The study demonstrates a high success rate in controlling severe scoliosis in infants when treated early and consistently.
- Supportive data from partially treated cases and initial results in children with spina bifida and scoliosis are also presented.
Conclusions:
- Early and unremitting management is highly effective in controlling even the most severe forms of infantile scoliosis.
- Aggressive early treatment protocols can prevent significant curve worsening in pediatric spinal deformities.
- The findings support the long-term benefits of early intervention for infantile scoliosis.
Abstract:
This is a study of children who first attended as infants with either progressive infantile idiopathic scoliosis or congenital scoliosis. All had a pattern of scoliosis in which early and damaging deterioration is inevitable. The infants were treated from before the age of three, initially by plaster casts and then a Milwaukee brace, followed at about the age of ten by correction and fusion. The cases were then observed to the end of growth or near that point. In the main study there were twelve cases, six of progressive infantile idiopathic scoliosis and six of congenital scoliosis, which were followed through this long period. Only one of the twelve had a curve worse at the end of growth compared with the initial radiograph as an infant; this one curve had increased only 16 degrees in almost as many years. Although small, the series does show that it is nearly always possible to control even the most serious scoliosis in an infant, if it is tackled early and unremittingly. There are supportive studies of children who have partially completed this regime, and interim results in a newer group of children with spina bifida and scoliosis.