Early onset scoliosis: what the primary care provider needs to know and implications for practice

The purpose of this article is to discuss the role of the primary care provider in the detection of and referral for early onset scoliosis. An overview of scoliosis including etiology, natural history, guidelines for physical examination, current practice for scoliosis screening, and available treatments will be discussed.

PubMed, OVID Medline, Psychinfo. Search terms: juvenile scoliosis, childhood onset scoliosis, early onset scoliosis, idiopathic scoliosis, and infantile scoliosis.

Scoliosis is classified depending on the magnitude, location, direction, and cause of the curve, and can lead to a variety of health effects if not treated. The greater the scoliosis curve and the earlier it presents, the more likely it may affect thoracic growth, inhibit cardiopulmonary function, and cause psychosocial distress.

Routine scoliosis screening should be incorporated into each healthcare maintenance visit beginning in infancy and continue into adolescence until the child reaches skeletal maturity. Curves with a scoliometer reading greater than 5° should be referred, and conservative treatment should be considered for curves that surpass 20°. If scoliosis is detected early, it may be possible to stabilize the curve from progressing and even prevent thoracic deformity and secondary complications from occurring.