Focus On Management of early-onset scoliosis

Early-onset scoliosis is defined as scoliosis diagnosed at the age of five years or less (Fig. 1).1 These patients may have congenital spine malformations and thoracic malformations, such as fused or absent ribs, but they may also have normal vertebral formation. Early-onset scoliosis is uncommon. The incidence of idiopathic scoliosis has been reported to be 1.5% and infantile scoliosis represents only 4% of this population.2 However, early-onset scoliosis is an important health issue. These children develop spinal deformities at young ages and if left untreated, are at risk for rapid deformity progression, cosmetic disfigurement and pulmonary insufficiency.3-6 Pehrsson et al7,8 reported that in patients with untreated scoliosis, the mortality rate increased in infantile-onset scoliosis followed by juvenile-onset scoliosis mainly due to respiratory failure (40%). The average age at death was 54 years but some patients died as young as 16 years.7-9 Postmortem findings of these children would show very small lungs with markedly decreased numbers of alveoli.10