Progressive infantile idiopathic scoliosis

Infantile idiopathic scoliosis is unique in that it differs considerably from idiopathic scoliosis seen in the older child. Early recognition of the progressive type is essential if serious deformity is to be prevented. Treatment must be aimed at controlling the curvature by serial casts and the Milwaukee brace to support the spinal column without interference with the local mechanics of growth. Most children eventually require spinal fusion, but this should be delayed until early adolescence. If a curvature cannot be controlled satisfactorily, however, surgical fusion may be indicated earlier than desired. Never should a curve be allowed to progress beyond 60 degrees. Two cases are presented to illustrate these principles.