Congenital scoliosis is defined as a curvature of the spine that is the result of malformations of the vertebral elements. The fact that the spine and spinal column ever form correctly is amazing given the complexity of the process from the embryological standpoint. Most of this development happens during the 3rd-6th week in utero (after conception). In spite of the opportunities for error, congenital malformations are relatively rare. Doctors think about congenital scoliosis in three groups: failures of formation, failures of segmentation, and combinations of these defects.
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Idiopathic scoliosis is the most common form of scoliosis in North America, affecting up to 2 % of the population. It’s usually caused by an adolescent growth spurt. In order for a physician to diagnose and treat idiopathic scoliosis, he or she must first rule out all other causes of scoliosis. Most idiopathic curves present in adolescence are painless, gradual, have a typical curve pattern (for example, a right thoracic curve), and the neurological exam is normal. Idiopathic scoliosis is much more common in females.
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Kyphosis or hunching over is normal in the thoracic spine. If you look at your child from the side, you will notice that there is a curve in the upper back where they are “hunched over”, and a curve in the lower spine (“sway back”). However, when kyphosis is greater than 50 degrees, it becomes easy to see and is considered abnormal. Most parents will attribute this to “poor posture”, but become concerned that despite their persistent reminders, their child will not stand up straight.
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The term “neuromuscular scoliosis” is used to describe curvature of the spine in children with any disorder of the neurological system. Common categories include cerebral palsy, spina bifida, muscular dystrophies, spinal cord injuries and so forth. Most of these children have as a unifying feature weakness of the trunk. As they grow and their trunk gets weaker, there is a progressive, collapsing deformity of the spine producing a long, c-type curve.
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