Prognosis

Early-onset scoliosis is a heterogeneous constellation of diseases. Prognosis is linked largely to the co-morbidities and deformity at the time of presentation.

During the first 2 years, lung development is significant. By year 8, alveolar maturation will level off. Those with limited thoracic function due to scoliosis development can see alveolar hypoplasia, abnormal ventilation, and decreased lung compliance. Cardiac issues such as cor pulmonale and pulmonary hypertension can also present. The inability of the thoracic to appropriately lung growth and function are known as thoracic insufficiency syndrome.

Prognosis of the deformity is related heavily to the skeletal maturity of the patient as well as a degree of deformity. Thoracic to sacral spine grows at approximately 2 cm per year for the first 5 years of life and then 1 cm per year from ages 5 to 10 with 1.8 cm per year until maturity. Rapid growth is seen in the first 5 years and then during the adolescent phase.

The rib-vertebral angle (RVAD) at the apical vertebrae is prognostic for the progression of early-onset scoliosis from idiopathic conditions. An RVAD of greater than 20 degrees an initial presentation is more likely to progress.

Reference

1. LeFever D, Menger RP. Infantile and Juvenile Scoliosis. StatPearls [Internet] January 2020