Q: Dr. Winter, would you begin by providing us with a definition of
congenital scoliosis?
A: Doctors would describe it as a condition due to congenitally anomalous
vertebral development, but it's easier to say it is a curvature of the spine
caused by birth defects in the spine itself.
Q: What sorts of birth defects cause congenital scoliosis?
A: The most common birth defect is called hemivertebra, which means half of one
side of a vertebra forms while the other side doesn't. Another defect is called
a unilateral bar, a condition where you will find three to four vertebrae stuck
or fused together on one side. At present, no one knows what causes these
defects.
Q: In the case of hemivertebra, how does it create a curvature?
A: All growing bones have growth centers, but if you're born with half a bone on
one side and the other side is missing, the side with the growth center will
grow faster than the other, and you end up with a curvature.
Q: Does congenital scoliosis occur more often in girls than in boys?
A: Yes, it occurs about 60% of the time n girls, 40% in boys. We do not know why
this is so
Q: When are doctors most likely to see signs of congenital scoliosis in
children?
A: We seldom see it at birth unless an x-ray has been taken for some other
purpose, such as pneumonia, or unless the child is born crooked. I have seen a
few children a week old who had 40-50 degree curves, but that's fairly rare.
More than likely, we'll see it show up later in life--for example, in a teenager
who's going through the growth spurt.
Q: In the case of the teenager, how would you know the youngster had
congenital scoliosis and not idiopathic scoliosis?
A: When you look at an x-ray and see abnormal bone, you know is congenital. With
idiopathic scoliosis, you won't see any abnormal bone. As your readers will
recall, idiopathic means a disorder that has no known cause.
Q: How many individuals in the U.S. population are affected by congenital
scoliosis?
A: Congenital scoliosis is not a common problem: approximately one person in
every 10,000 is affected, and that number has remained fairly stable over the
years.
Q: Do congenital curves always worsen?
A: No. A small number, only about 1-2 % of congenital curves, will get better by
themselves. Another 2.5% stay right where they are and never require treatment,
though we will monitor these twice a year with x-rays to make sure they've
stabilized. Roughly 75% do worsen and require treatment.
