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Published on: October 16, 2013
Infantile idiopathic scoliosis in the newborn
1Department of Paediatric Orthopaedic Surgery, Hospital Sant Joan Déu, Hospital Universitari de la B. U., Barcelona, Spain.
Insights
Early intervention for infantile idiopathic scoliosis can resolve the condition. This study found that flexible curves often disappear, and conservative treatment can straighten spines in some stiff cases, highlighting the potential for early treatment to induce resolution.
Area of Science:
- Pediatric Orthopedics
- Spinal Deformities
- Developmental Pediatrics
Background:
- Infantile idiopathic scoliosis (IIS) is a spinal deformity present at birth.
- The etiology and optimal management of IIS remain areas of investigation.
- Understanding intrauterine influences and early treatment efficacy is crucial for IIS management.
Purpose of the Study:
- To investigate the role of intrauterine forces in the development of IIS.
- To determine if early treatment can lead to the resolution of progressive IIS curves.
- To correlate radiographic findings with curve severity and treatment outcomes.
Main Methods:
- Retrospective review of 7 patients diagnosed with IIS within the first month of life.
- Mean follow-up of 16 years.
- Radiographic assessment including rib vertebral angle difference (RVAD) and curve rigidity.
Main Results:
- Two patients were conjoined twins, demonstrating intrauterine molding.
- Six patients had an initial RVAD > 20 degrees; 5 presented with stiff curves.
- Flexible curves resolved spontaneously within the first year.
- Conservative treatment for stiff curves (6-24 months) resulted in a straight spine in 4 of 5 patients after skeletal maturity; one developed an adolescent curve.
- Two skeletally immature patients remained without scoliosis.
Conclusions:
- Early treatment of potentially progressive infantile idiopathic scoliosis can induce resolution.
- A significant rib vertebral angle difference (>20 degrees) correlates with curve rigidity.
- While intrauterine molding was observed in conjoined twins, its broader role in IIS requires further investigation.
Abstract:
We have reviewed 7 patients (5 boys and 2 girls) with infantile idiopathic scoliosis which was present at birth and was diagnosed at ages from 1 day to 1 month. The mean follow up was 16 years. The objectives were to discover whether intrauterine forces play a role in the aetiology and to determine whether early treatment of a potentially progressive curve can induce resolution. Two infants were male conjoined twins and were united by skin over the posterior sacrum. Six infants had a rib vertebral angle difference greater than 20 degrees in the first radiograph and 5 had stiff curves. In 2 with flexible curves, the deformity disappeared by the end of the first year. The 5 with stiff curves were treated conservatively for 6 to 24 months. Growth has now been completed in 5; 4 have a straight spine and one developed an adolescent curve of 26 degrees. The 2 who are still growing have no scoliosis. Intrauterine moulding was only demonstrated in the conjoined twins. There was a correlation between the rib vertebral angle difference above 20 degrees and the rigidity of the curve. Early treatment of a potentially progressive curve can lead to resolution.
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