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Scoliosis & Spinal Deformity

The spine is a line—in most people.

When someone has scoliosis, the spine (also called the backbone) isn’t a straight line. Instead, it’s curved, usually in an “S” or “C” shape. Although scoliosis can affect people of all ages, it’s most commonly found in older children (ages 10 to 12) and teenagers.

In general, scoliosis is nothing to worry about—it can usually be treated, it’s rarely painful, and most kids with scoliosis can go on to lead healthy, normal lives.

Types And Causes

There are three main types of scoliosis, and each one has a different cause.

Idiopathic scoliosis: In about 80% to 85% of cases, scoliosis is idiopathic, meaning the cause is unknown. This type tends to run in families. Boys often get a pass here—idiopathic scoliosis is usually found in adolescent girls.

Congenital scoliosis: Some cases of scoliosis are congenital, meaning a child is born with the condition. It happens before birth, when a child’s spine doesn’t form correctly. It’s possible for congenital scoliosis to be associated with other health issues, like kidney or heart problems.

Neuromuscular scoliosis: If a child has a disorder that affects her spine, brain, or muscles, she may develop scoliosis. Some of the most common conditions that can cause scoliosis are muscular dystrophy, cerebral palsy, and spine injury.

 

Symptoms

The main symptom of scoliosis is its appearance—you can usually see the “S”- or “C”-shaped curve. This curve can also make it look like one hip or shoulder is higher than the other.

It’s possible that a child will notice back pain, or feel that her back seems “tired” after standing or sitting for a long time. But usually, scoliosis is a relatively symptomless condition.

 

Diagnosis

Screening for scoliosis begins with a simple test—the Adam’s forward bend test. The child will be asked to bend forward while she’s standing with her feet together, knees straight, and arms hanging on both sides. The physician will look for signs of a curve in her spine, or for a difference in the shape of her ribs on each side.

Once this test is complete, the physician will also check for other signs of scoliosis:

  • One hip or shoulder appears to be higher than the other.
  • The head is not centered over his hips.
  • The patient has difficulty moving the spine in all directions.
  • The pelvis is tilted.

 

The physician will also use imaging tests, like X-rays or magnetic resonance imaging (MRI), to get clear pictures of the spine. These pictures will help her determine the severity of the curve, since some curves are more severe than they appear during a physical exam.

 

Prevention

Scoliosis is usually unpreventable. So while telling a kid to “stand up straight” may help her appear more confident, it won’t prevent scoliosis. In fact, her bad posture can actually be a result of scoliosis.

And there’s no connection between scoliosis and heavy backpacks or playing sports. While they can cause back pain, they won’t cause scoliosis (or make existing scoliosis worse). There is one exception—neuromuscular scoliosis may be caused by a spine injury. Encouraging a child to play sports safely may help her keep her spine safe.

 

The OIC Scoliosis Team

At the OIC’s Scoliosis Clinic, treatment options are provided based on the spinal maturity of the patient, the degree and extent of the curvature, the severity and location of the curve and the potential for progression of the curvature.

Based on your child’s condition your team could include:
The Pediatric Orthopaedist specializes in the musculoskeletal system of children. They provide surgical interventions when necessary such as tendon lengthening.

The Pediatrician reviews medical issues and coordinates the general healthcare of the patient, in addition to working with the orthopaedic surgeon for pre-operative assessments if surgery is indicated and overseeing medical issues for hospitalized patients.

The Nurse Coordinator assists in making sure all medical orders are carried out, and provides case management and nursing assessment for the patient.

The Orthotist works with the team to prevent unequal or unbalanced muscle groups which can lead to deformities as the child grows.

You may also work with physical therapists who will help plan, develop, implement and monitor a physical therapy plan to help reduce pain, or improve or increase mobility.