13 September 2017
Scoliosis is something we see often in our practice here at Westchester Health Pediatrics. It’s not extremely common but neither is it rare, and it’s a condition that we feel parents need to be aware of so they can recognize the symptoms in their child and if need be, seek treatment.
Scoliosis shows up most often during growth spurts, usually when children are between 10 and 15 years old. Scoliosis that is diagnosed during the teen years usually continues into adulthood. The greater the angle of the spinal curve, the more likely it is to increase over time.
What causes scoliosis of the spine?
When looking at someone’s back, the spine should run straight down the middle. When a person has scoliosis, the backbone curves to the side in a pronounced S shape. About 1 in 25 adolescent girls and 1 in 200 teenage boys develops scoliosis.
The angle of the curve may be small, large or somewhere in between, but anything that measures more than 10 degrees is considered scoliosis. You can often tell that someone has scoliosis by their body posture. They tend to lean to one side, have a sunken chest and have uneven, rounded shoulders.
Scoliosis can occur as a complication of polio, muscular dystrophy or other central nervous system disorder, but 80% of cases are idiopathic—of unknown cause. Very often, a family member has also had scoliosis. If you or one of your children has scoliosis and you have other children, make sure they are screened regularly.
But having said that, some kinds of scoliosis do have clear causes. These are divided into two types: structural and nonstructural.
In nonstructural scoliosis, the spine works normally but looks curved. This may be due to one leg being longer than the other, muscle spasms or inflammations (such as appendicitis). When these problems are treated, this type of scoliosis often goes away.
In structural scoliosis, the curve of the spine is rigid and cannot be reversed. This can be caused by:
- Cerebral palsy
- Muscular dystrophy
- Birth defects
- Genetic conditions such as Marfan syndrome and Down syndrome
Old wives tales that are not true: Contrary to what some people believe, scoliosis is not caused by childhood sports injuries, heavy backpacks or poor posture.
2 most common ways scoliosis is treated
The decision to treat scoliosis depends upon both the severity of the curve as well as the patient’s skeletal maturity. Patients who are less skeletally mature have more growth ahead of them and therefore their curve is more likely to progress.
- Curvature of the spine of more than 25 degrees may call for bracing. There are two main types of orthopedic back braces: 1) The Milwaukee brace has a neck ring and can correct curves anywhere in the spine, and 2) the thoracolumbosacral orthosis corrects deformities involving the vertebrae of the thoracic spine and below. The device fits under the arm and wraps around the ribs, hips and lower back. Scoliosis patients can expect to wear the brace all but a few hours a day until their spinal bone growth is complete, which for girls is usually between ages 17 and 18, and between 18 and 19 for boys. Wearing an orthopedic brace usually interferes only minimally with a person’s physical activity, with contact sports and trampolining being the only “off-limits” activities.
- The procedure to surgically correct scoliosis is called posterior spinal fusion and instrumentation, and is typically recommended when the spine’s curvature is 40 degrees or more. It fuses the affected vertebrae using metal rods and screws to stabilize that part of the spine until it has fused together completely. People who have this surgery still face some restrictions on physical activity but can stop wearing the brace.
How you can help your child manage the difficulty (physically and emotionally) of wearing a back brace
Only about 50% of teenage scoliosis patients wear their braces. This is why parents play such a significant role in getting their child to comply with their doctor’s instructions, hopefully by explaining how it will pay great benefits in the future.
At the same time, we stress to our parents that they need to be sensitive to the tremendous impact this condition has on a young person’s body image, self-confidence and social standing at school, not to mention the restrictions it puts on their physical activity. In some cases, we refer young patients who are having trouble with the emotional aspects of scoliosis to get professional help from a therapist or counselor.
Does your child have scoliosis? Come see us, we can help.
If your child has scoliosis, or if you are concerned that he/she might be developing it, please make an appointment with Westchester Health Pediatrics. One of our pediatricians will examine your child, make a diagnosis and if warranted, refer you to a specialist for further diagnosis and treatment. Working together, we’ll make sure your child gets the help he/she needs. Whenever, wherever you need us, we’re here for you.