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Scoliosis

The Who, What, and When of Scoliosis Treatment

Your child’s care provider or a school nurse might suspect scoliosis after performing preliminary screenings. One common test involves having the child bend over while the care provider examines the spine’s curve.

If that screening points to a possibility of scoliosis, our pediatric orthopaedist care providers at OIC can do a full diagnosis by:

  • Performing a physical examination
  • Discussing your child’s medical history
  • Taking X-rays of your child’s spine
  • Measuring the degree of curvature on the x-rays

Typically, a diagnosis may start with the Adams forward bend test. The child bends forward at the waist with their knees straight and arms stretched downward. This lets a care provider see signs like whether a hip is higher on one side or a leg that appears shorter than the other.

If that screening points to possible scoliosis, a care provider can do a full diagnosis by:

  • Performing a physical exam
  • Reviewing your child’s medical history
  • Taking X-rays or magnetic resonance imaging (MRIs) of your child’s spine
  • Measuring the degree of curvature on the X-rays

Here’s some great news: Scoliosis is often treatable—but only if you reach out to us to get your child properly diagnosed. So don’t hesitate to reach out to us. The correct diagnosis and treatment plan can provide your child with a higher quality of life.

For milder cases of scoliosis, the best treatment might be for us to simply monitor your child to make sure the curve doesn’t worsen. In many children, the curve will not worsen as they grow.

More severe cases may need treatment to prevent your child from developing issues with breathing or heart function. This may mean bracing or surgery to ensure that your child can have the best quality of life possible.

So what does scoliosis treatment look like?

Scoliosis is measured by the degree of curvature in your child’s spine. A curve higher than 10 degrees is typically considered a sign of scoliosis.

Generally, the milder the curve, the less severe it is—and the less likely it is that your child will need treatment.

However, because children are still growing, the severity of their scoliosis can change. So as months or years pass, the curve can grow more severe, and treatment might be needed. This is why having a care provider monitor your child’s scoliosis is so important.


 

Which Scoliosis Treatment Is Right for Your Child?

The 3 main scoliosis treatment options are:

  1. Monitoring
  2. Bracing
  3. Surgery

Determining the right treatment option for your child depends on several factors, including:

  • Where the curve is located
  • How severe the curve is
  • Your child’s age
  • How much growing your child has left

 

Scoliosis Treatment: Monitoring  

Fortunately, in most cases, scoliosis is mild and doesn’t require active treatment.

For kids whose spinal curves are less than 25 degrees, the care provider might recommend regular appointments every 6 to 12 months to monitor your child’s spine. Then, follow-up X-rays will be scheduled to make sure the curve is not increasing as your child grows.


 

Scoliosis Treatment: Bracing

Bracing might be used to treat children and teens who are still growing and their scoliosis is between 25 and 45 degrees.

Bracing may not correct the curve in your child’s spine, but it can stop the curve from getting worse.

Most braces go under the arms and will fit your child’s body. The care provider will tell you how many hours each day your child needs to wear the brace.

As your child grows, the brace might need to be replaced. Also, keep in mind that:

  • Daytime braces are often worn for 16 to 23 hours a day.
  • Because braces are form-fitting, they can usually be covered up under looser clothes.
  • With the care provider’s approval, your child can remove the brace to participate in sports.

 

Scoliosis Treatment: Surgery

If your child’s spinal curvature is 45 to 50 degrees or more, or if bracing didn’t help, the care provider might recommend surgery.

Unlike monitoring and bracing, scoliosis surgery—called spinal fusion—is intended both to correct the curve and to prevent it from returning or worsening.

The surgeon will realign the curve, then fuse the section of straightened vertebrae. Once fused, that part of the spine will no longer grow. And the fused vertebrae will heal together as if they are one bone.


 

Other Treatment Options For Young Patients With Scoliosis

Casting: Children under the age of 3 may undergo serial casting to correct scoliosis. A special traction table is used when applying a cast. Casts are changed every 3-4 months.

Growth-Friendly Spinal Instrumentation: Young patients with large or progressive curves may require implantation of instrumentation that controls the curve, but allows spine growth. New, magnetically-controlled growing rods (MAGEC Rods) are used to lengthen the spine without general anesthesia.

For children who need surgery, most can return to noncontact sports within 3 months. Care providers usually recommend they avoid contact or high-impact sports (such as football) for 6-12 months.

Surgery does not increase a girl’s odds later in life of having complications during a pregnancy or delivery.

While every child’s recovery is unique, here is a general timeline for recovery from scoliosis surgery.

  • 3-5 days after surgery: Return home from the hospital (Yay!)
  • 2 to 4 weeks: Return to school and social activities (Double yay!)
  • 2 to 4 weeks: Pain medication should no longer be needed
  • 6 or more weeks: Drive again (Um...only if you’re old enough)
  • 6 to 12 weeks: Begin bending forward and lifting heavier objects (Yep. Textbooks, too!)
  • 3 to 6 months: Start playing non-contact sports again (Triple yay! )
  • 6 to 12 months: Return to all normal activities, including contact sports (Pow!)

Potential Problems That Untreated Scoliosis Can Cause

It’s important to get your child’s scoliosis treated. Especially in severe cases, it can lead to serious problems, including:

  • Difficulty breathing
  • Low back pain
  • Chronic pain
  • Nerve damage
  • Decreased self-esteem

Questions to Ask Your Child’s Care Provider

You might be wondering which scoliosis treatment is right for your child. The reality is, many different factors go into that decision. Understanding these factors can go a long way toward easing any anxiety or concern you might have as a parent.

Here are some questions to ask your child’s care provider about scoliosis treatment.


 

General Questions About Scoliosis

  • How severe is my child’s scoliosis? Have the care provider explain the degree of the curvature.
  • Which scoliosis treatment option(s) might be right for my child?
  • What might happen if my child’s scoliosis is not treated?

 

Questions About Monitoring Scoliosis

  • What tools will you use to monitor my child’s scoliosis?
  • How often will my child need to come back for follow-up?
  • When will my child no longer need further scoliosis monitoring?
  • Can my child still be active and play sports with scoliosis?
  • What should I be looking for at home?

 

Questions About Scoliosis Bracing

  • Is bracing a good option for my child’s scoliosis treatment?
  • What kind of brace will work best for my child?
  • How often will my child have to wear the brace?
  • When will my child be able to not wear the brace?
  • Are there any activities my child should not do while wearing the brace?
  • Tell me about day-to-day care for the brace? How can we avoid damaging it?

 

Questions About Scoliosis Surgery

  • Can you explain the surgery to me in steps?
  • Will my child need more than one procedure?
  • What are the benefits and risks of scoliosis surgery for my child?
  • What do you recommend for pain management during my child’s recovery?
  • Will my child have to miss school for the surgery?
  • What can we do to keep my child on track with school work during the hospital stay?
  • When can my child be active again after surgery?
  • What about sleeping? Should my child avoid certain positions or avoid sleeping with siblings?
  • What kind of support should we have in place at home during recovery?
  • Are there activities my child should avoid after surgery?
  • How long does recovery take?
  • Will my child need to wear a brace after surgery?
  • Will my child need physical therapy after surgery?