Paediatric Spine and Scoliosis

Overview:

The spinal problem in children is usually uncommon. In normal condition, the spine runs straight down the back. However, in some children, abnormalities in spine is noticed. The spine gives a curved appearance. This curved spine is known as scoliosis. This may occur during early childhood or prior to birth.

Paediatric-Spine-and-ScoliosisCauses:

A variety of reasons exists which can cause the spine to become curved. The causes include:

  • Undeveloped bones or vertebrae during pregnancy
  • Repeated Injury or trauma
  • Genetic deformity
  • Malignant spinal diseases

Symptoms:

The symptoms of spinal deformity changes with age of the child. The common symptoms noticed are:

  • Shoulder heights differ in length
  • Uneven waistline
  • Head not centered with body
  • Back pain
  • Collided pelvis
  • Difficulty in movement or breathing

Treatments:

Early detection of scoliosis helps to provide proper treatment. Certain tests are done by the doctor to observe the curve in the spine. The different diagnostic tests include:

  • EOS imaging
  • X-rays, MRI scan, or CT scan
  • Positron emission tomography (PET) scan
  • Pulmonary function tests
  • DEXA scan or bone scan
  • Ultrasound

According to the test results achieved, the exact treatment procedure is determined. It may be non-surgical treatment or surgical treatment.

  • Non-surgical Treatment

In majority of cases, non-surgical treatment methods are sufficient to control spinal curving. The treatment options include:

  • Observation

In mild curves, no treatment is often required. These spinal curvatures disappear with time. However, a proper observation of symptoms is required to detect any progression.

  • Bracing

In severe cases where bending exceeds 25 degrees, braces are commonly used. Braces are used to immobilize the child’s spine. This limits the symptoms from further worsening. They usually avoid the need for surgery.

  • Surgical Treatment

Innovative techniques are used to perform spinal surgery. The common surgical procedures include:

  • Spinal Fusion

Scoliosis may affect the growth of the child. Spinal fusion is an effective method for permanent stabilization of spine. During surgery, the bones are selected from the hip bone or pelvis. These selected bones are joined with bones in the back. Until healing, to hold the bones in straight position, metal rods are used within the spine.

  • Growing Rods

This type of spinal surgery is successful in correcting the spinal curvature. In addition, it allows continuous growth of the spine. The growing rod surgery is performed at the back of spine. In this procedure, one or two rods are used to span the spinal curve. Thus, damage to growth tissue of the spine is avoided. The rods are placed both above and below the curve. However, in every six months, it is required to expand the rods. In some cases, the growth goes beyond a certain limit. In such cases, the rods are removed.

  • VEPTR

In severe conditions, the lung and rib development is also affected. In such cases, the child is also diagnosed with thoracic insufficiency syndrome. Vertical Expanding Prosthetic Titanium Ribs (VEPTR) is an innovative surgical device to improve these symptoms along with spine curve. In this method, the curved spine is stabilized. Also it allows the ribs, lungs and spine of child to grow. The VEPTR can also be surgically adjusted.

Post-treatment:

A re-evaluation in every six months is required to determine proper functioning of spine. An additional spinal fusion is, sometimes, necessary in addition to growing rods or VEPTR. Ice packs give relief from pain and swelling. Regular dressing of the wound is required. Sponge bath is recommended for few weeks. A complete recovery is seen in 12 months.

Risks:

The possible risks with treatment of scoliosis are:

  • Injury to nerves around spine
  • Difficulty in walking
  • Pseudarthrosis
  • Bleeding
  • Infection

 

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