Scoliosis Doesn’t Have to be Scary

A common spine condition, scoliosis is a deformity of the back where the spine has a side-to-side curve. About three million new cases of scoliosis are diagnosed in the U.S. each year. Most new cases are found in children ages 10 to 12 years old but both younger and older children can have scoliosis as well.

While a scoliosis diagnosis may seem scary, it’s important to remember that it’s a very manageable condition, especially when it’s diagnosed early. Most children with scoliosis live normal, healthy lives and can participate in all sports and activities. Only about one-third of children with scoliosis need treatment, and of those, many more require braces or other conservative treatments while a small number need surgery to correct scoliosis.

Scoliosis: Back to Basics
A normal spine appears straight when you look at the child’s back. A child with scoliosis may have a noticeable curve but the curve may not be obvious in larger children. If the curve of the spine measures ten degrees or more, the scoliosis is diagnosed.

Symptoms can occur differently in each child. Some of the most common scoliosis symptoms include:

• Difference in shoulder height
• The head not centered with the rest of the body
• Difference in hip height or position
• Difference in shoulder blade height or position
• Difference in the way the arms hang beside the body when the child stands straight
• Difference in the height of the sides of the back when the child bends forward
• Looks like the child is leaning to one side
• Noticeable prominence in the back

Generally, scoliosis is a painless condition that children don’t always notice right away. “I recommend that parents get their children an annual physical exam, such as a well-child visit, so that conditions like scoliosis can be diagnosed as soon as possible,” says Dr. Bill Accousti, an orthopedic physician at Children’s Hospital who treats children with scoliosis. He adds, “Early diagnosis is key to preventing the spine’s curves from worsening during growth spurts.”

What causes scoliosis?
Some children are born with scoliosis, while others develop it later in life, often during growth spurts before puberty. More girls than boys are affected. In most cases, the cause of scoliosis is unknown. It tends to run in families. There is no way to prevent it. Children do not get scoliosis because of heavy backpacks or bad posture.

Diagnosing Scoliosis
Finding scoliosis early is important for treatment. If left untreated, scoliosis can cause problems with heart and lung function. Primary healthcare providers, and even some school programs, routinely look for signs of scoliosis in children.

Your child’s healthcare provider can diagnose scoliosis with a complete health history of your child and a physical exam. Your child may also need X-rays to measure the curve of the spine and confirm the diagnosis.

My child has scoliosis. Now what?
If a healthcare provider has diagnosed your child with scoliosis, the next step is to determine if it needs treatment or can simply be monitored. Most cases are mild enough to monitor without the need for treatment.

Treatment will depend on your child’s symptoms, age, general health and how severe the curvature is. The goal of treatment is to stop the curve from getting worse and prevent deformity. Treatment options may include:

• Observation and repeated exams. Your child will need to see his or her healthcare provider on a scheduled basis to check on the curve of his or her spine. Whether a curve gets worse often depends on the amount of skeletal growth remaining. The curving of the spine often slows down or stops after a child reaches puberty.
• Bracing. If your child is still growing, he or she may need to wear an external torso brace to prevent further worsening of scoliosis.
• Therapy. In certain cases, your child may benefit from physical therapy and other forms of exercise/stretching.
• Surgery. Your child may need surgery when the curve measures 45-50 degrees or more on an X-ray and conservative treatment has not slowed down the progression of the curve.

“Even the small percentage of children who require surgery go on to live healthy lives.  We send kids back to all sports and activities after they heal from their surgery,” says Dr. Accousti.

Children’s Hospital Orthopedics Department has specialists who treat scoliosis and a clinic dedicated to children with scoliosis. To make an appointment, call 504.896.9569.