Early onset idiopathic scoliosis involves individuals from birth to age ten years and includes different forms of scoliosis infantile and juvenile idiopathic scoliosis, congenital, neuromuscular and syndromic subtypes. The infantile category includes patients from birth to age three. Patients who present with idiopathic scoliosis at such a young age present a special set of circumferences. These patients have a large amount of growth potential and thus their curvatures are at risk for severe progression or worsening.
A majority of patients who present under age three will have curvatures that will spontaneously improve and even disappear over the course of months or years. Rarely, these patients will require a brace, casting, or surgery. For patients with juvenile idiopathic scoliosis (between ages 3 and 10) many of these patients will have highly progressive curvatures requiring bracing and often surgery. The key to success in the treatment of these conditions is early aggressive treatment with bracing in order to control curves and to maximize the patient’s growth. Often surgery is required, but this is delayed for as long as possible.
There are cases in which curve progression is so great and the deformity is so severe, that surgery cannot be delayed. In patients under eight years of age, a “growing rod” procedure can be done in which spinal growth is preserved, but implants are placed in the spine and correction of the deformity is done without a fusion procedure. The MAGEC rod is a new type of instrumentation that allows gradual correction of scoliosis and growth by bringing the patient back to an office setting rather than the operating room where lengthenings are performed using a magnet outside of the skin rather than through operations as was previously required. Following several years of these "growth" lengthenings of the spine, a definitive, final spinal fusion is performed. This approach allows the trunk to grow, minimizes spinal deformity, and most importantly allows lung development to occur to preserve a normal life span for the patient.
Patient Story 1
Jesse first came to see Dr. Lonner at the age of 2 years and 8 months for severe infantile idiopathic scoliosis. Dr. Lonner recommended the growth rods option, as it allows her spine to continue growing and her lungs to develop. The growth rod has been extended several times to accommodate her growth during childhood. The x-rays below show the first extension at the age of 4½ years. The first picture is Jesse with Dr. Lonner at age 8. The second picture is Jesse and her mom with Dr. Lonner after she underwent a final spinal fusion at age 13.