Unusual presentation of vertebral endplate Modic changes in congenital scoliosis associated with pain: a report of two cases

Congenital scoliosis is not normally associated with pain in young children. We are presenting two cases of young patients with congenital scoliosis and moderate to severe pain. There were no spinal cord abnormalities found in these patients. The magnetic resonance imaging and CT scan revealed disc degeneration with Modic changes at the apex of the congenital scoliosis. We hypothesized that the mechanical instability resulting from poor spinal element formations associated with congenital scoliosis was responsible for causing the disc degeneration and endplate changes. Modic changes have been reported to be associated with pain in degenerative conditions of the spine. Both patients underwent a posterior spinal fusion and instrumentation, which relieved their pain immediately.