Overview
Congenital scoliosis involves abnormal vertebral development leading to spinal curvature, often without associated pain in young children. However, cases can present with significant pain due to mechanical instability and associated disc degeneration and Modic changes at the apex of the curve 1.Diagnosis
Clinical Presentation: Presence of spinal curvature and pain in young patients 1.
Imaging Studies: MRI and CT scans essential to identify disc degeneration and Modic changes at the apex of the scoliotic curve 1.
Neurological Assessment: Rule out spinal cord abnormalities through detailed neurological examination and imaging 1.Management
Surgical Intervention: Posterior spinal fusion and instrumentation recommended for cases with mechanical instability and significant pain 1.
Pain Relief: Immediate pain relief observed post-surgery in reported cases 1.Special Populations
Pediatrics: Congenital scoliosis in children can present atypically with pain due to mechanical instability and disc changes 1.Key Recommendations
Consider imaging (MRI, CT) to evaluate disc degeneration and Modic changes in pediatric patients with congenital scoliosis and unexplained pain 1 (Evidence: Moderate).
Posterior spinal fusion and instrumentation may be indicated for mechanical instability and pain relief in congenital scoliosis 1 (Evidence: Weak).
Regular neurological assessment is crucial to exclude spinal cord abnormalities in patients with congenital scoliosis 1 (Evidence: Expert opinion).References
1 Siribumrungwong K, Gupta S, Gupta MC. Unusual presentation of vertebral endplate Modic changes in congenital scoliosis associated with pain: a report of two cases. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society 2016. link