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Scoliosis & Spinal Deformities

When there is an abnormal side-to-side curve in the spinal column it is called scoliosis. Most cases of scoliosis are idiopathic, meaning that there is no known cause for the disorder and it typically affects more females than males. Children with a family history of spinal curavature are at greater risk for scoliosis.

Children born with abnormalities of formation or segmentation of the spinal elements have what is called congenital scoliosis. Congenital scoliosis affects about 20% of the population that is the result of abnormal malformations of the vertebral. By part of one or more vertebrae being abnormally formed, the spine begins to take an abnormal curvature. 

Other children have scoliosis due to a variety of neurologic or muscular diseases. 

Untreated, scoliosis can cause subsequent deformity in the ribs, internal organ, and a change in body shape. Unless parents seek earlier evaluation, children are usually screened for this scoliosis through school screening programs. The scoliosis screening can determine if the child has a curve in their spine and the degree of the curvature. Once screened, an orthopaedic spine specialist can provide treatment options to correct the degree of the curvature and stop the progression of the curve.

Diagnosis of Scoliosis
Finding scoliosis is easy when the back is examined closely, but it can be missed if you are not looking for it. Sometimes clothes don't hang properly. For example, one pant leg may be longer, or a skirt hem doesn't look level. A shoulder blade may look higher and be seen through clothes or when wearing a swimsuit. Parents or friends might notice the curve, but most curves are found through a school-screening program or by a pediatrician. A trained examiner can detect even a slight curve when a child bends over to touch his or her toes. A referral is often made to a pediatric orthopaedic physician if a curve is suspected. Scoliosis is diagnosed by an X-ray of the spine and is measured in degrees. If the curve measures more than 10 degrees, it's considered to be scoliosis.

What are the types of curves?

Curves occur in the spine between the neck and the pelvis and are named based on their location. The most common type is in the upper back (thoracic), and tends to curve to the right. Other curves are in the lower (lumbar) spine. many children have both types of curves.

Treatment and Rehabilitation of Scoliosis
At the Orthopaedic Institute for Children (OIC) Scoliosis Clinic, treatment options are provided based on the spinal maturity of the patient, the degree and extent of the curavature, the severity and location of the curve and the potential for progression of the curvature.

Scoliosis treatment ranges from observation and orthopaedic bracing to (in some cases) surgery. The OIC pediatric orthopaedic surgeon will discuss the options and the appropriate treatment with the patient and their family.

Treatment depends on the degree of the curve, when it's detected and how much growing the child has left. Smaller curves may not require treatment other than periodic checks by the physician.

If a curve is greater than 20 degrees and the child is still growing, the physician might recommend wearing a brace. Scoliosis bracing won't correct a curve, but it will help prevent it from progressing during growth spurts. The brace is only worn while the child is growing and must be worn as prescribed by the physician in order to be effective.

If a curve is advanced, the physician may suggest scoliosis surgery to correct the scoliosis. Allowing a large curve to progress could interfere with heart and lung funciton in later years and can result in pain as an adult. The most common type of operation is called possterior spinal instrumentatoin and fusion. This procedure prevents the curve from progressing and helps correct the spinal curvature.

Scoliosis is a treatable condition, and it should not be allowed to become a disabling one. When treated, it should not affect the child's ability to lead a normal life.

Our Team
At OIC, a team will see your child in the Scoliosis Clinic. The team includes the pediatric orthopaedic surgeon, nurse practitioner, pediatrician and therapists as needed. Our goal at OIC is to hlep each child function at the highest possible level.

Additional Information on Scoliosis:
Scoliosis and Kyphosis Brace Wear
Scoliosis Surgery (English)
Scoliosis Surgery (Spanish)