Early Onset Scoliosis (EOS)

The Center for Early Onset Scoliosis is led by Michael Vitale, MD, Chief of Pediatric Spine and Scoliosis Service at NewYork-Presbyterian Morgan Stanley Children’s Hospital and the Ana Lucia Professor of Pediatric Orthopaedic Surgery at Columbia University College of Physicians and Surgeons. More than 400 patients under the age of five are seen each year in our Center.

Check out this video located on the Growing Spine Foundation Website that is an Introduction to Early Onset Scoliosis for Patients and Parents

What causes Early Onset Scoliosis?

While more than 100,000 children in the U.S. are diagnosed with scoliosis each year, most patients are diagnosed between ages 10 and 15 with Adolescent Idiopathic Scoliosis. Scoliosis identified at birth or up to the age of eight is rare, and is categorized as Infantile Scoliosis, Juvenile Scoliosis or Congenital Scoliosis.

The cause of Infantile Scoliosis is unknown; however considerable medical research has led to the development of hypotheses that include intrauterine molding, postnatal positioning and genetic influences.

Early Onset Scoliosis (EOS) is often associated with other diagnoses including congenital chest wall deformities, neuromuscular disorders such as cerebral palsy, myelomeningeocele or muscle disease, or spinal pathologies such as a tumor.

There are many different causes of early onset scoliosis therefore it is critical to perform the appropriate examination and tests. In addition to close observation, a careful neurologic exam, a spinal MRI and a series of x-rays to review if other structural problems exist are sometimes performed. Other associated problems may dictate other examinations or consultations including cardiac, pulmonary or renal function testing.

Early Onset Scoliosis is a rare occurrence, requiring special knowledge and experience to manage the complex issues surrounding this condition.

Types of Early Onset Scoliosis

EOS can be divided into 3 different categories based on age and type of curve.  You can find more information about each type by selecting their link.  In fact, our group has developed the classification of EOS.

• Infantile Idiopathic Scoliosis
  Occurs before the age of 3 and is seen more often in boys than girls. Most cases resolve spontaneously, but some may progress to a more severe curve. Treatment may include observation, physical therapy, bracing, casting and, under rare circumstances, surgery. Read more in-depth information on infantile scoliosis.
• Juvenile Idiopathic Scoliosis
  This is defined as scoliosis occurring between the ages of 3 and 9.  It is found more often in girls than boys. These curves are generally at a high risk for progression to more severe curves.  They usually require bracing or casting and many will go on to require surgery. Read more in-depth information on juvenile scoliosis.
• Congenital Scoliosis
  While most cases of scoliosis are considered ‘idiopathic’ and occur during childhood without a clear cause, a small number of children develop a curvature of the spine even before birth, during fetal development. These cases are referred to as congenital scoliosis.  Congenital scoliosis occurs when bony portions of the spine fail to form properly or segments fuse together.  The defects in the spine can be minor, involving only one segment of the vertebral column, or the condition can involve nearly every level and result in a more severe deformity. Treatment ranges from observation to surgery, depending on the appearance of the spinal curvature.  It can be associated with cardiac, renal or spinal cord abnormalities so often additional testing is performed to further evaluate for these. Read more in-depth information on congenital scoliosis.

Treatment of Early Onset Scoliosis (EOS)

We have the EOS low dose xray machine at the Children’s Hospital office location. Please take some time to learn more about this machine and how we have taken steps to improve the quality and safety of your child’s care. Treatment for the different types of early onset scoliosis may include observation, physical therapy, bracing, casting, and surgery.

View the video of Dr. Vitale talking with patients about EOS

Additional information

• Innovative Techniques in Scoliosis
  • VEPTR/Growing Rods
  • Anterior Vertebral Body Tethering (AVBT)
  • MAGEC Rods
  • Scoliosis Casting
  • Scoliosis Bracing
• Conservative Care of Spine and Scoliosis
  • Schroth Therapy
  • Scoliosis Bracing
  • Scoliosis Casting

Resources

• App: Scoliosis Tracker for iPhone and iPad
• Book: Scoliosis: A Guide for Parents and Families
• Book: What to Expect: Conservative Scoliosis Care
• EOSQ24 and EOSQ24 Scoring Sheet
• National Scoliosis Foundation
• Scoliosis Research Society
• Setting Scoliosis Straight
• SHIFT scoliosis
• Scoliosis Quarterly
• Infantile Scoliosis Outreach Program
• Infantile Scoliosis Book: Cole and the Crooked Flower
• http://www.espine.com
• http://www.iscoliosis.com
• Article: A Closer Look at Children’s Hospital of New York
• Children’s Spine Foundation Annual Report 2015
• 2019 Annual Report for PSSG
• Childrens Spine Foundation

See Full List of Conditions Treated