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Spinal Deformity & Scoliosis

Scoliosis Treatment for Children

Scoliosis refers to curvature of the spine. Our team has the expertise and experience to treat scoliosis – and we see new patients with scoliosis every single day.

This condition is particularly common among girls, typically around the sixth grade. Most often, scoliosis can be treated with observation or bracing. We use a variety of different types of braces, depending on the child's needs.

What Causes Scoliosis?

In most cases, the cause of scoliosis is unknown. Less common types of scoliosis may be caused by neuromuscular conditions such as cerebral palsy, spinal birth defects, or injuries or infections of the spine. 

Signs of Scoliosis in Kids & Adolescents

Signs of idiopathic scoliosis typically begin in the preteen years and is more severe in girls than boys. Parents may notice a fullness on one side of their child's back when bent over or that their child's clothes don't “hang right.”

Early scoliosis signs and symptoms may include:

  • One shoulder or shoulder blade (scapula) that is higher than the other
  • One shoulder blade more prominent than the other
  • A curve in the spine or midline of the back
  • The head is not centered with the rest of the body
  • An increased space between one arm and the body (uneven waistline)
  • Uneven hips
  • On forward bend, a “rib hump” or one area of the back is higher than the other side

Back pain, leg pain, and changes in bowel and bladder habits are not commonly associated with idiopathic scoliosis. A child experiencing these types of symptoms requires immediate medical evaluation by a physician.

Pediatric Scoliosis Screening Recommendations

Although only 5 percent of those with scoliosis will require treatment, scoliosis screening is important in order to detect it early and begin treatment if necessary.

Diagnosing Scoliosis

X-rays are the primary diagnostic tool for scoliosis. By looking at your child's back, you might be able to see a curve. But by taking X-rays, UH pediatric spine specialists can look at the spinal column clearly and measure the curve in degrees.

X-rays of your child’s spine are taken from the back and sometimes from the side. As an alternative to a conventional X-rays, your doctor may order an EOS X-ray, which is a technique that captures information-rich images using a significantly lower amount of radiation than conventional X-rays. Occasionally, magnetic resonance imaging (MRI) may also be recommended.

In addition to X-rays, the doctor will take a full medical history, conduct a thorough physical examination and perform neurological tests to check for:

  • Muscle weakness
  • Numbness
  • Abnormal reflexes

Although there is research being done to look for a hereditary link, a genetic test for idiopathic scoliosis does not exist.

It is important to know that not all children diagnosed with scoliosis will need treatment. For mild cases, UH Rainbow pediatric spine specialists can often prevent the condition from worsening or causing other complications such as a rotating spine, uneven hips and breathing challenges.

In these situations, when mild scoliosis is present but no active treatment is recommended, your child should be examined by a UH spine specialist every four to six months, especially during the years of rapid growth, to make sure the curve is not getting worse.

What Will Happen if Scoliosis Is Not Treated

For cases of moderate to severe or progressive scoliosis, it is important to treat for two main reasons:

  • Health problems – While health problems may not show up until children are older, changes in heart and lung function can occur if their curve is allowed to become severe. In addition, although children may not have pain now, abnormal posture could lead to limited activity, discomfort and arthritis as they get older.
  • Appearance – Scoliosis signs and symptoms affect the shape of your child's body. If the curve increases too much, the physical changes may be apparent even when he or she is clothed, affecting self-esteem and body image.

Early-Onset Scoliosis

Early onset scoliosis (EOS) is a curvature of the spine that is diagnosed in patients under the age of 10.

Types of Scoliosis

There are several types and causes of early-onset scoliosis:

  • Congenital: Caused by misshaped bones, or vertebra, in the spine
  • Neuromuscular problems, such as cerebral palsy, myelodysplasia or muscular dystrophy, in which muscles cannot hold the spine straight
  • Genetic syndromes that affect more than one part of the body
  • Idiopathic: In which there is no clear cause of the scoliosis

Diagnosing and Treating EOS

Doctors use an X-ray of your child’s spine to confirm an early-onset scoliosis diagnosis. If EOS is diagnosed, your child’s doctor may recommend additional testing. Often magnetic resonance imaging (MRI) and/or other tests may be ordered, depending on the situation. As your child grows, radiographs will be used to follow the curve over time to see if it is getting bigger with growth.

There is a wide range of treatments for EOS, and each patient’s treatment is unique to their specific condition. Some patients may only need to be monitored while growing. Patients with small to moderate size curves may wear a brace or be fitted with a series of casts. Braces and casts are normally used to prevent the curve from getting worse and are very effective in some patients. Patients with more severe curves may need surgery to correct their curve. Pediatric orthopedic spine specialists at UH Rainbow Babies & Children’s have expertise in diagnosing and treating a variety of conditions that cause EOS. They are up to date with all the current nonoperative and operative techniques, as they are a participating center in the international early onset scoliosis research section of the Pediatric Spine Study Group.

Support

Children and families who are undergoing treatment for EOS have the benefit of a team approach, which includes their surgeon and our pediatric orthopedic nurse team. Since EOS is variable and treatment can be challenging, our patients get excellent support from the nursing team who assist with teaching, casting, brace management and more.

Treatment for Idiopathic Scoliosis

UH Rainbow Babies & Children’s Hospital offers a variety of advanced surgical and non-surgical options to treat scoliosis in children and adolescents. Depending on the type of scoliosis, the progression of the spinal curvature, and the age of the patient, our team can evaluate each individual child and develop a treatment plan specific to that child’s needs.

Recommended pediatric scoliosis treatments may include: