Some Factual Stats

Greetings and a Reminder:

I write this blog as we go through ET Mehta Casting with our daughter Olivia. The blog is intended to inform, possibly inspire, and raise awareness of Infantile Scoliosis and its treatment/cure. For more information please check out http://www.infantilescoliosis.org/ 

Yesterday was a fun, light hearted post. Today I'm going to get serious.....ha ha! Well, kind of!

No, seriously. ;-) This entry is to give you a little more concrete information on Infantile Scoliosis and some statistics. 

According to the Scoliosis Research Society (SRS) Infantile Scoliosis is 

"first diagnosed in a child between birth and 3 years old. Congenital scoliosis (malformed and/or connected vertebrae) is also diagnosed during this period. However, these curves are not included in the infantile idiopathic scoliosis category. Many infantile curves will resolve without treatment. Those that do not resolve can be difficult to manage. Your scoliosis specialist may suggest a magnetic resonance imaging (MRI) study to determine if there are any abnormalities of the spinal cord or spinal column. The study is more difficult in small children because sedation or even general anesthesia may be necessary to relax the child enough to obtain good images. Many infantile curves are left-sided curves in the thoracic (chest) area – in contrast to the right-sided curves more common in adolescents. It is more common in boys than girls. In some patients, there is an increased association with hip dysplasia, mental retardation, and congenital heart disease. Many other infants are healthy and normal and simply have a small curvature of the spine."

Olivia had an MRI done and happily it all came back clear. Here are some pics of her in recovery:

SRS continues by describing treatment. Why I feel this part is important is because the treatment for Infantile Scoliosis is not the same as treatment for adolescent scoliosis, because the body makeup is different at this age. 

"When scoliosis occurs at a very young age, there are several important implications for

management and treatment. For example, a 60^o idiopathic curve (cause of scoliosis unknown) in a teenager is typically managed quite successfully with a posterior instrumented fusion. The same 60^o curve in a 2-year old is managed very differently. The 2-year old needs many years to maximize their trunk height and lung size. A fusion in a young child would prevent further growth of the instrumented segment. Furthermore, depending on the type of instrumentation used, the anterior spine may continue to grow leading to 'crankshaft phenomenon'. In this situation, the scoliosis continues to progress despite the posterior fusion. For this reason, other treatments have been developed for the management of early onset scoliosis. These techniques take into account the growth of the spine as well as the growth of the rib cage and lungs. If implants are necessary, multiple expansions or lengthenings may be necessary (usually twice per year) to keep up with growth in the young spine."

Here are some additional facts from the Scoliosis Center of New York Presbyterian Hospital:

• Most infants that develop abnormal curves do so in the first 6 months of life
• Infantile scoliosis is a rare condition, accounting for less than 1% of all cases of idiopathic scoliosis
• The condition is more common in Europe than in the U.S.
• For unknown reasons, the curve in the spine tends to bend to the left in infants with scoliosis. However, girls who develop curves that bend to the right have a worse prognosis than other infants.
• While there are several types of scoliosis for which the causes or origins of the disease are well understood, infantile scoliosis is considered idiopathic, which means the causes are, for the most part, unknown.
• For reasons not yet understood, it has been found that children who develop scoliosis before the age of 5 are more likely to have cardiopulmonary abnormalities in infancy.
• Infants with idiopathic scoliosis usually do not experience any pain from the condition.

Though this type of scoliosis is considered idiopathic there have been some hypotheses as to what causes it. The Scoliosis Center of New York says:

"There is evidence to suggest that intrauterine molding may be responsible for the development of infantile scoliosis. With intrauterine molding, the spine is affected during fetal growth because of abnormal pressures exerted by the walls of the uterus on one side of the fetus’ body, or abnormal positioning of the fetus within the uterus. This hypothesis is supported by epidemiological data, which demonstrate that there are higher rates of plagiocephaly (a slight flattening of one side of the head) and developmental dysplasia of the hip (a condition that affects one of the hips) on the same side as the spinal curve in infants with idiopathic scoliosis. A second theory suggests that postnatal external pressures are exerted on the spine after birth, perhaps due to an infant being positioned on his/her back for extended periods of time in the crib. This may explain the higher incidence of the condition in Europe, where infants have traditionally been positioned more on their backs and less on their abdomens, compared to in North America. However, a few years ago the American Academy of Pediatrics (AAP) announced a formal recommendation that newborns be positioned on their backs when sleeping, due to research studies suggesting that Sudden Infant Death Syndrome (SIDS) and other respiratory problems are associated with babies being positioned on their abdomens. Despite the possible relation of this recommended position to infantile scoliosis, our pediatric orthopaedic group supports the policy of the AAP. A final hypothesis for a possible cause of infantile scoliosis is that of genetic inheritance. While the exact genes that may be involved have yet to be identified, research has shown that there is a higher incidence of the condition within some families, lending considerable weight to the probability of a genetic component.

Despite the notable amount evidence for these hypotheses, much about the condition remains to be discovered and fully understood. As a result, there is ongoing research at a number of academic medical centers throughout the U.S., attempting to further uncover the keys to the development of infantile scoliosis and improve the treatment and prevention of the condition."

I have highlighted one of the hypotheses here, because if I were to pick one that would best fit Olivia that would be it. She had reflux in her first few months preventing us from having her on her back for extended periods. She slept on an incline. Then she was able to tolerate her back but HATED being placed on her stomach. Tummy time for her was like a chore. It would not surprise me if further research suggests that this hypothesis is true.

Well, there is your scoliosis lesson for this evening. If you "just can't get enough" in addition to citing the websites mentioned here I have also included an additional list of websites for you to peruse at your leisure. 

Resources:

Scoliosis Research Society. MedImagery.net. 2012. <http://www.srs.org/patient_and_family/scoliosis/idiopathic/infantile/index.htm>.

Division of Pediatric Orthopaedics. David P. Roye, Jr., M.D., Joshua E. Hyman, M.D., Francis Y. Lee, M.D., Michael G. Vitale, M.D., M.P.H.. 2012. Morgan Stanley Children's Hospital of New York.  <http://www.childrensorthopaedics.com/Scoliosis.htm#infantile>.

For Additional Information:

National scoliosis foundation: http://www.scoliosis.org/

Scoliosis Research Society: http://www.srs.org/

Scoliosis World: http://www.scoliosis-world.com/cat21.htm

Scoliosis Support Group: http://www.geocities.com/Athens/Troy/4314/index.html

http://www.espine.com

http://www.iscoliosis.com