There are three different types of scoliosis that can occur in children — idiopathic, congenital (present at birth) and neuromuscular. Our spine specialists at the Children’s Wisconsin AIM Spine Center treat all of them.

Idiopathic scoliosis

Idiopathic scoliosis is the most common, making up to 85% of all cases. It is a combination of genetic, endocrine/hormonal, environmental and growth factors that cause scoliosis. There are two types of idiopathic scoliosis:

• Infantile idiopathic: Comes within the first three years of life, is rare. Most curves are to the left. Often these curves are in otherwise healthy infants and resolve on their own. However rarely these curves can progress and require treatment. Rarely they can be associated with other medical or developmental problems.
• Juvenile idiopathic: This occurs in kids ages 4-10. These kids have a higher risk of spinal cord problems.

Congenital scoliosis

Congenital scoliosis is caused by one of the following:

• Failure of the vertebrae to form normally
• Absence of vertebrae
• Abnormally formed or fused vertebrae

It often requires further evaluation, including MRI of the spine and evaluation of your child's heart and kidney development. Congenital scoliosis is watched closely, especially during the first five years of life when the spine is growing rapidly and then again during adolescence. Bracing is not usually helpful.

Neuromuscular scoliosis

This is associated with many neurological conditions, including cerebral palsy, Spina bifida, muscular dystrophy, paralytic conditions, chiari malformation or tethered or spinal cord tumors. It results in a C-shaped, or long, irregular curve and is thought to be caused from the abnormal muscle/nerve pathways. The severity of neuromuscular scoliosis is often dependent on what the underlying neurological condition is and what nerves and muscles are involved. A multidisciplinary approach is needed to determine the best treatment and outcome for these patients.

Our specialists use a combination of history, physical exam and diagnostic test for diagnosis and cause of spine injuries. These tests include:

• X-Ray
• EOS — low dose X-ray machine used for imaging the spine
• CT Scan
• MRI (Magnetic Resonance Imaging)

The goal of treatment is to stop the progression of the curve and prevent deformity. At Children's Wisconsin, a multidisciplinary approach is taken and treatment is individualized for your child based upon age, growth, scoliosis curve size, expectations for the course of the condition and the family's opinion or preference. Common treatments include:

• Observation and repeated examinations: Observation and repeated examinations may be necessary to determine if the spine is continuing to curve. Progression of the curve depends upon the amount of skeletal growth or the skeletal maturity of the child. Curve progression slows down or stops after the child reaches puberty. Sometimes physical therapy is included especially if the patient is having pain or the family would like to seek other methods.
• Bracing: Bracing may be used when the curve measures between 25 to 40 degrees on an X-ray, but skeletal growth remains. The type of brace and the amount of time spent in the brace will depend on your child's condition.
• Surgery: Surgery may be recommended when the curve measures 50 degrees or more.

Expert pediatric care: The Children's Wisconsin AIM Spine Center is the only one in the state that offers experts who specialize in pediatric scoliosis from across a field of disciplines- orthopedics, neurology and neurosurgery, physical medicine and rehabilitation, chiropractic care and psychology and physical and occupational therapy. From diagnosis through treatment, we’ll partner with your family to develop the best care plan for your child. We use noninvasive treatment options whenever possible. If your child needs spinal surgery, our highly skilled surgeons use the most advanced techniques and technology to deliver optimal results and shorter recovery times.