Incomplete Formation of Vertebrae

During fetal development, the spine and vertebral column develops first as a single column of tissue and later becomes segmented to form the bony vertebrae. Sometimes a vertebra will not completely form, becoming what is known as a hemivertebrae. This vertebra will cause a sharp angle in the spine and a curvature that can worsen as a child grows. The abnormality can occur at 1 vertebra in the spine or many vertebrae.

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Failure of Separation of Vertebrae

If during this time of vertebral development, the tissue does not fully separate, it may result in a partial fusion (bars) between vertebrates. As a result, as the child grows, the connection will prevent the spine from growing evenly and properly, resulting in a curve. Both failures of separation and incomplete formation can occur together.

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Congenital scoliosis is usually not painful and is normally detected during routine exams when a child reaches adolescence. Physical signs include:

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• Child leans to 1 side
• Ribs are more prominent on 1 side
• Tilted, uneven shoulder
• Uneven hip
• Weakness, numbness or loss of coordination, if spinal cord is affected by curve

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If your child has symptoms of congenital scoliosis, your doctor will recommend other tests to check for abnormalities, including:

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• X-rays: By looking at X-rays of your child’s back from behind and the side, a doctor can determine how severe the curve is and if there is an abnormal vertebra.
• CT scans: Provide doctor detailed images of your child’s spine showing the size, location and shape of any abnormalities.
• Magnetic resonance imaging (MRI): Provides images of the soft tissues within the body. This test will be done at least once to check for abnormalities that cannot be seen on X-ray.

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Non-surgical Treatments

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Observation

When a child grows, the curve can get worse, making the deformity more noticeable. Therefore, children with a small curve are monitored to make sure the curve does not progress. A doctor will schedule appointments every 6–12 months to monitor the curve.

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Bracing /Casting

Bracing and casting are rarely used. When they are used, they help control the part of the spine that does not have vertebral defects.

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Surgical Treatments

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Spinal Fusion

The abnormal segments of the spine are fused together to create 1 continuous solid bone. The growth of the spine is stopped, and it prevents the curve from progressing and getting worse.

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Hemivertebrae Removal

The abnormal vertebrae are removed, partially correcting the curve. Metal implants are placed to help stabilize the surrounding segments as they fuse together.

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Growing Rods

For young children with significant curves, rods are attached to the spine and/or ribs to control the curve and to allow the spine to continue to grow. The rods are lengthened every 6–8 months until the child is fully grown, at which time a spinal fusion is performed.