By Stephen G. George, MD
Medical Director of Pediatric Spinal Surgery
About Dr. George
Scoliosis affects millions of children in the U.S. each year. Girls seem to be slightly more at risk than boys, as are children whose siblings or parents have the condition.
Here is a helpful overview about scoliosis and treatment methods.
What is Scoliosis?
The spine has a natural “S” curve when it is viewed in profile and should appear straight when viewed from the back. If your child’s shoulders seem to be uneven or if the spine appears to curve to the left or right when viewed from the back, scoliosis may be present. Approximately 3 percent of children ages 9 to 14 are diagnosed with scoliosis each year.
What are Signs or Symptoms of Scoliosis?
Here are signs of symptoms parents can watch for, particularly if there is a family history of scoliosis:
- Uneven shoulders and shoulder blades
- Uneven hips
- Ribs that protrude in one area
- Muscles that bulge to one side of the back
Is Scoliosis Caused by Poor Posture? Backpacks?
Scoliosis is caused by asymmetry in the growth and development of the spine and the surrounding muscles and tends to be an inherited trait. Heavy backpacks are not recommended because they can lead to back discomfort and poor posture. Nevertheless, backpacks do not cause scoliosis.
How is Scoliosis Diagnosed?
The first step in diagnosing scoliosis is to perform a physical examination. Your child’s physician will check for uneven shoulders, protruding shoulder blades and examine the child’s spine while he or she bends forward. If it is suspected that the child has scoliosis, an X-ray can be performed to assess the extent of the curvature.
Why is Treatment Important?
Scoliosis tends to advance when a child goes through puberty and enters a period of rapid growth. Scoliosis is best treated when diagnosed early. Severe scoliosis is associated with continued worsening of the curve, back pain, reduced height, and lower self-esteem.
How is Scoliosis Treated?
Treatment of scoliosis in children is best coordinated by a pediatric orthopedic surgeon specialized in spinal disorders. The doctor may recommend an evaluation every four to six months to see if the curve is progressing or not.
The Center for Spinal Disorders at Nicklaus Children’s recognizes the importance of offering the most advanced technology to ensure your child receives the highest quality care possible. That’s why Nicklaus Children’s has invested in its patients by acquiring the latest in spinal imaging, the EOS Imaging System. EOS Imaging creates full-body 3D images of patients in a natural, standing position while producing much less radiation than traditional scanners do.
Coming soon in late 2021!
Nicklaus Children’s has acquired the EOSEdge, the latest EOS imaging technology on the market. EOSEdge uses a unique setting called Flex Dose that adjusts the amount of radiation the patient receives in order to minimize the long-term impact. This setting minimizes exposure in areas of the body whenever possible, while still delivering the high resolution images needed for our doctors to make treatment decisions.
When Might a Brace be Considered?
Braces for Scoliosis: Children with moderate curves may be prescribed a brace in addition to non-operative treatments. Braces are designed to slow and sometimes stop the progression of the curve. Some braces can fit beneath loose clothing, while other types of braces can be worn exclusively at night. The doctor will work with the family to determine the best brace for the child.
Surgery for Scoliosis: If the curve progresses and has potential to worsen, the physician may recommend surgical options, including spinal fusion. In this method, the surgeon attaches screws and rods to both sides of the spine, which gently straighten the spine. Small bone grafts from the spine and ribs are then affixed next to the spine. As these bone grafts heal, they will become solid, maintaining the new position of the spine and preventing curvatures from recurring. Most surgical patients are able to resume most activities within six months to a year of surgery.