Scoliosis is the term used to denote the sideward curve in the spine. It is not just a simple curve in the spine but in actuality is a complex, 3D deformity that develops during childhood. Scoliosis is a derivative of ‘skol’ whose synonym is twists and turns.

Infantile scoliosis is that which affects children below the age of 3.  Rather than to classify scoliosis based on the age as infantile, juvenile , adolescent etc, the newly preferred term is early onset scoliosis or late onset scoliosis, the range being 5 years of age.

In a majority of cases of scoliosis, there is no specific reason that could be pointed as being the cause for infantile scoliosis and such scoliosis is termed as being idiopathic scoliosis. But a minor percentage, around 20% have a definite cause and they are further divided into two types as structural scoliosis and non-structural scoliosis.

The rate of occurrence of infantile scoliosis is low, compared to the other disorders that usually affect infants and children. In North America, it is as low as 1% and in Europe as low as 4%. Of those found diagnosed with infantile scoliosis, there are different patterns of obtaining scoliosis depending on the gender of the child. In males, 60% affected with infantile scoliosis are of the early onset type; 90% of such early-onset scoliosis resolve spontaneously but the remaining 10% may progress to a worse crippling condition. In the case of the female gender, 90% of diagnosed infantile scoliosis is of the late-onset type and require regular monitoring to prevent it from becoming worse.

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The method of diagnosis of scoliosis can be studied under three categories

Laboratory Studies

Material is collected related to the family heredity patterns and checked to find any scope of infantile scoliosis being due to a genetic malformation.

Imaging Studies

A radiograph of the spine of the child is taken, usually by holding the child up in a vertical position. The use of a paediatric immobiliser or positioner could also be used.  The radiograph is used to collect the progression or regression of the curve of the spine.  Antero-posterior radiographs are also used to determine the severity of the curve.

Other Studies

A CT Scan is performed prior to surgery to confirm and work out the details of the surgery, if it is to be undertaken depending on the health and capability of the patient to handle a surgery. A MRI scanning is also done for infantile scoliosis. A minimum of the Cobb angle to be greater than 20 degrees is considered as suitable for surgery.

There is yet to be a definite reason for the cause of infantile scoliosis, although hypothesises have been submitted based on epidemiologic evidences are follows:-

-          The mechanical factors that an infant faces, while still in the womb are responsible for scoliosis on the same side of the body.

-          The possibility of multifactorial causes, such as genetic factors that function as carriers for diseases such as collagen disorders, joint laxity etc.

-          Possibility of older mothers from malnourished families, breech position of the baby while in foetus, premature and low-birth-weight babies.

The recommended treatment for Scoliosis is surgery. The many factors that need to be considered whether to opt for surgery or not are as follows:

1.      Time of development of the curve

2.      Location and degree of the curve

3.      Response of the curve to external treatment, like a brace.   

4.      Rate of advancement of the curve

Parents’ acceptability to the appearance of the spine.