Infantile scoliosis affects children during the first 3 years of life and is undoubtedly the most aggressive of the various types of scoliosis in pediatric orthopedics.
Infantile scoliosis is quite rare compared with the juvenile and adolescent forms, all of which are classified by the age of onset: the infantile variant may show up in the first year of life when the child has not yet begun to walk.
It represents 1%–2% of all scoliosis types and is more common in males than in females.
Infantile scoliosis is a severe pathology, with a rate of deterioration proportional to the growth rate during this period of life.
In the first year, a child grows on average 25 centimeters, more than at any other life stage, even adolescence.
This implies a rapid worsening of scoliosis, especially when the child begins to walk and the back collapses.
It is difficult for parents to identify the presence of infantile scoliosis, even if very attentive mothers notice it before obtaining a diagnosis from a specialist or pediatrician.
The first year can be dramatic, due to a worsening of the curve, which can double in severity within a few months.
Curves of 80 °–100 ° can occur and should be treated as soon as possible.
Although such aggressive scoliosis usually ends with surgery, in the literature we can also find data concerning some cases of nonsurgical resolution.
A study by Dr. Min Mehta in the 1980s showed that early treatment with a cast in the first year of life could be decisive for complete resolution.
Therefore with the correct therapy exploiting a period of rapid growth, it was not necessary, according to that study, to intervene in adolescence when the curves begin to worsen again.
How to intervene?
It is essential to turn to superspecialized centers because, in these cases, so rare and dramatic, even specialists who treat idiopathic scoliosis often have never seen infantile scoliosis.
It is necessary to intervene promptly, with an accurate diagnosis: a non-surgical treatment requires an immediate prescription for bracing, but it is impossible in young children to combine it with exercise therapy.
Given the speed of growth, the brace is changed frequently, and short braces, which do not involve the neck (as the Milwaukee brace does), can be used.
Instead, speaking of surgery today, there are cutting-edge surgical techniques with the installation of extendable bars which avoid repeating the intervention frequently: these are still experimental techniques; at present, we do not have certain scientific data at end growth.