Assessment of the relationship between perinatal factors, early psychomotor development and congenital malformations of the locomotor system with the incidence of idiopathic scoliosis to order earlier screening of children at risk

Idiopathic scoliosis is a developmental disorder of the spine with lateral curvature in the frontal  plane and Cobb angle of more than 10 degrees. Idiopathic scoliosis with minor Cobb angle is an aesthetic disorder, but a significant  Cobb angle can cause damage to the heart and lung function. Because its aetiology is unknown,  treatment is symptomatic, focused on early recognition and timely treatment to prevent progression.  The objective of the study was to identify predictors for the development of idiopathic scoliosis  by analysis of perinatal factors, early development and congenital malformations of the locomotor  system in order to identify children at risk by history and clinical examination. We analysed 100  subjects with idiopathic scoliosis, 79 girls and 21 boys aged 6-18 years with a Cobb angle of 15  degrees or more, and a control group of 100 subjects without idiopathic scoliosis. Data were  entered into the questionnaire, and statistical analysis was done by Mann-Whitney  test, Levene  test, χ2-test, Fisher exact test and t-test. In the idio- pathic scoliosis group, significant   differences  were recorded in the following parameters:  complications/rest  during pregnancy,  crawling stage, menarche, and mutation/voice change in boys, expression of flat feet, dorsalgia,  leg shortening and deformities of the musculoskeletal system. Idiopathic scoliosis was diagnosed  late in nine children aged 15-18 years; according to the type of sco- liosis, 4C type was recorded  in 55, 3C in 20, E in 18 and n3n4 in seven subjects. In conclusion, there was a significant  between-group difference in development, symptoms and deformities of the skeletal system,  identified by history and examination before the onset of clinical signs of idiopathic scoliosis,  indicating an increased risk of scoliosis development later in life. We have designed a question-  naire to be filled out for younger clinically inconspicuous children in order to identify those at  an increased risk, so we can follow-up them more often, diagnose idiopathic scoliosis earlier and  start optimal treatment on time.

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