A musculoskeletal disorder that is detrimental to the shape of the spine (backbone), a spine that has scoliosis will not be straight but rather curved into a letter C or S shape. And because it’s congenital, having been present since birth, it most likely occurred due to a problem during early fetal development. However, oftentimes the condition is not identified until a child grows during their post-natal years.
The spinal curvature that presents with congenital scoliosis is harder to correct, however upwards of 25 percent of children born with the condition will never see it progress or worsen. Of course this means that the vast majority of those born with congenital scoliosis will see a worsening of their condition and will require active and ongoing treatments as their body grows.
Known to be a non-genetic disorder, there are several reasons why congenital scoliosis may occur. One reason is “formation failure,” meaning that, during fetal development, the bones of the spine don’t form completely and vertebrae become abnormally shaped. Such shapes may present as triangles or wedges, therefore altering the direction of the spine’s development and causing a curvature. Another root cause of the condition is known as “segmentation failure,” meaning certain spinal bones separate unnaturally from one another during development. This incorrect fusing of vertebrae causes the sides of the spine to grow at inconsistent rates, causing the spinal curve. And lastly, congenital scoliosis can be caused by a combination of formation and segmentation failure, known as a “mixed deformity.”
As the developmental problems of the spine inherent with congenital scoliosis can run the gamut from barely noticeable to quite severe—and can affect one or more areas of the spine concurrently—the treatment options vary from case to case.
Because children suffering from congenital scoliosis have an absence of pain, recognizing the signs and symptoms of the condition are harder to see. However, sure signs of a spinal curvature include unevenness in the hips and shoulders—where one side appears higher or lower than the other—and a shoulder blade that projects out to a greater degree than the other. Congenital scoliosis is more often noticed during a standard post-birth examination, and if not detected at this point it may not be noticed until years later.
Quite often, babies born with congenital scoliosis suffer from other health issues as well, such as the spinal deformities known as lordosis and kyphosis. Additionally, problems in the development of the ribs or rib cage may occur, affecting the natural shape of the chest and impairing normal breathing (thoracic insufficiency syndrome), and they may experience problems with their bladder or kidneys.
To reach a diagnosis of congenital scoliosis, a physician will review a child’s medical records and complete a physical examination. During the exam the doctor will check for unevenness in the shoulders or rib cage; whether or not the head is centered; if the pelvis is uneven; if there are skins abnormalities; and if there is a general symmetry or asymmetry in body. Also, imaging will factor prominently into a diagnosis of congenital scoliosis, which will often utilize x-rays, CT scans and MRIs of the spine.