Question 1

What's the difference between early onset scoliosis and the scoliosis teenagers get - why is it more serious?

Accepted Answer

Early onset scoliosis (EOS) occurs before age 10 (usually ages 0-5) during critical lung and spine development, while adolescent idiopathic scoliosis (AIS) develops after age 10 when most lung growth complete. KEY DIFFERENCES: (1) LUNG DEVELOPMENT: Lungs grow rapidly until age 5-8, with 80% of lung capacity developing by age 8 - severe EOS curves restrict chest expansion, preventing normal lung growth (thoracic insufficiency syndrome), leading to lifelong breathing problems, recurrent pneumonias, and early death in worst cases; AIS doesn't significantly affect lung development as lungs already mature. (2) CURVE PROGRESSION: Young children's spines grow rapidly (spine doubles in length from birth to age 5), so EOS curves worsen faster and more severely than AIS - curve can progress 5-10 degrees per year in EOS vs 0-5 degrees in AIS. (3) TREATMENT COMPLEXITY: EOS treatment aims to control curve WHILE allowing continued spine/chest growth (requires complex growth-friendly surgery like growing rods with repeated lengthenings), whereas AIS can be observed until skeletal maturity then single fusion surgery if needed. (4) HEART PROBLEMS: Severe EOS restricts chest causing pulmonary hypertension (high blood pressure in lungs) and right heart failure; AIS rarely affects heart. BOTTOM LINE: EOS is medical emergency requiring aggressive treatment to preserve lung development and prevent life-threatening complications - adolescent scoliosis is cosmetic/back pain concern with much better prognosis. If your child diagnosed with EOS, specialist will monitor lung function closely (breathing tests every 6-12 months) and recommend surgery earlier/more aggressively than for teenage scoliosis.

Question 2

What are the risks and challenges of growing rod treatment - is it worth putting my young child through multiple surgeries?

Accepted Answer

Growing rods involve 10-15 surgeries over 5-7 years (initial placement, lengthenings every 6 months, final fusion) - this is major commitment with significant risks, but often necessary for severe EOS curves where bracing failed and curve threatens lung development. RISKS: (1) INFECTION: 10-15% develop wound/implant infection requiring rod removal, IV antibiotics 4-6 weeks, temporary bracing, then new rods inserted months later (adds 6-12 months to treatment timeline) - (2) ROD BREAKAGE: 15-25% experience rod fracture (from falls, normal wear) requiring revision surgery to replace broken rod - (3) AUTOFUSION: Spine may spontaneously fuse around rods (10-20% of patients), limiting further growth and defeating purpose of growth-friendly surgery - (4) CURVE WORSENING: Despite rods, 20-30% experience curve progression requiring larger fusion later - (5) ANESTHESIA RISKS: Repeated anesthesia exposure concerns some families (neurodevelopmental effects unclear, but most pediatric anesthesiologists reassure risk very low with modern anesthetics) - (6) PSYCHOLOGICAL IMPACT: Frequent hospitalizations, missing school, body image concerns, scars. BENEFITS: Growing rods achieve 60-70% curve control while gaining 3-5cm spine height over treatment period - critically, they allow chest expansion preserving lung development (patients treated with rods have significantly better lung function than those with untreated curves). ALTERNATIVES: (1) MAGNETICALLY CONTROLLED GROWING RODS: Avoid repeated surgeries for lengthenings (lengthened in clinic with external magnet) - reduces infection risk, anesthesia exposure - but more expensive and may have limited availability; (2) BRACE AND WAIT: For borderline curves (45-50 degrees), some families choose aggressive bracing with close monitoring, delaying surgery 1-2 years hoping child older and fewer lengthenings needed - risks curve progressing beyond salvageable point. MAKING DECISION: Discuss with spine specialist: child's curve severity and progression rate, lung function, age (younger children need more lengthenings), family's ability to commit to frequent surgeries/follow-up, and child's overall health. For severe progressive curves (greater than 50-60 degrees) in children under 5-6, growing rods usually only option to preserve lung function and prevent life-threatening complications - benefits outweigh risks despite treatment burden.

Question 3

Will my child be able to participate in normal activities, sports, and school during EOS treatment?

Accepted Answer

Most children with EOS participate in school and modified activities throughout treatment, but restrictions depend on treatment type and curve severity. BRACING: Children in braces attend regular school, participate in PE (with brace on), and play non-contact sports - brace removed for swimming, showering - contact sports (football, rugby, martial arts) not recommended due to spine instability risk - most children adapt well to brace within 4-8 weeks (initial discomfort and self-consciousness fade). GROWING RODS: After initial surgery (6-8 weeks recovery), children return to school and light activities - avoid contact sports, trampolining, gymnastics (high rod breakage risk) - swimming, walking, cycling generally safe - lengthening surgeries typically scheduled during school holidays (minimize missed school) - after lengthening, child needs 1-2 weeks off school, then gradual return to activities over 4-6 weeks. ADAPTIVE PE/SPORTS: Work with school to modify PE activities (child participates in warm-ups, stretching, non-contact drills but sits out contact games) - some children participate in adaptive sports programs (swimming, archery, boccia). PSYCHOSOCIAL: Children with EOS face body image concerns (visible back asymmetry, brace, surgical scars), frequent medical appointments, and feeling different from peers - psychological support important (school counselor, psychologist, peer support groups through scoliosis associations) - many children resilient and cope well with support. SCHOOL ACCOMMODATIONS: Discuss with school: (1) Extra time between classes (slower walking with brace/after surgery), (2) Elevator access, (3) Modified PE participation, (4) Carrying lighter backpack or using locker between classes, (5) Sitting position in classroom (may need special chair or standing desk), (6) Home tutor during recovery periods, (7) Excused absences for medical appointments (frequent follow-ups required). PROGNOSIS: With treatment, most children with EOS achieve reasonable quality of life - they attend regular school, have friends, participate in many activities - restrictions are frustrating but manageable - after final fusion surgery (typically ages 12-14), most resume near-normal activities within 6-12 months (some permanent restrictions on high-impact sports). AUSTRALIAN RESOURCES: Scoliosis Australia (support group), National Disability Insurance Scheme (NDIS may provide funding for equipment, therapies if EOS meets disability criteria), school disability support services.

Medical Disclaimer

Curved Spine in Young Children (Early Onset Scoliosis)

📖What is Curved Spine in Young Children (Early Onset Scoliosis)?

🔬What Causes It?

⚠️Risk Factors

You may be at higher risk if:

🛡️Prevention