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. All of our braces are used at night to minimize any impact to your child’s quality of life.
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 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.
Optimally, children should be screened yearly in grades five through eight. Scoliosis screenings can be conducted in a group setting in private areas of a school, such as a locker room or nurse's office.
Experts recommend screeners use the hands on/clothes on method of screening, in which children keeps their clothes on to protect their privacy and decrease their anxiety. With this method, the screener places her hands on the child's shoulders and hips to test for symmetry and requests that the child do a simple forward bend.
Since scoliosis may develop at any time before growth is completed, it is important that your child's spine be checked regularly until they have finished growing.
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. 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
- Abnormal reflexes
Although there is much 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.
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.
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:
A brace is used to prevent moderate curves (25-40 degrees) from getting worse until your child is finished growing. It is very effective but not always successful. Braces will not cure or correct the curve.
Some braces are worn only at night for eight to 10 hours. Other braces are worn about 22 hours a day. The type of brace and the amount of time spent in the brace will depend on what your doctor feels is best for your child. Braces are worn until the child is fully grown. They are worn under the clothes and participation in activities is not restricted.
- GROWING RODS
Growing rods are effective for very young children with severe spinal deformity. This technique allows the spine and lungs to continue growing as the child grows. Unlike traditional casting and halo traction, growing rods help young patients integrate easily into school and their social environment.
The procedure involves the insertion of one or two rods under the back muscles and attaching them above and below the spine’s curve. They are adjusted about every nine months to enable growth, although newer systems grow with the child and do not require frequent returns to the operating room. Our highly-trained orthopedic surgery team offers two of these new and unique surgical procedures which include:
- The Shilla™ Growth Guidance System: This system uses a special non-locking screw at the top and bottom of the growing rod, which allows the rod to slide through the screw heads as the child’s spine grows, while still providing correction of the spinal deformity.
- MAGEC™ Growing Rod: This uses a magnetic device inside the growing rod, which can be expanded painlessly and noninvasively via an external remote control.
The Shilla and MAGEC devices were approved by the Food and Drug Administration in 2014; both are part of treatment offered by the pediatric scoliosis experts at UH Rainbow.
- SCOLIOSIS SURGERY
If the scoliosis curve is greater than 45 or 50 degrees and is disrupting everyday life, spinal fusion surgery may be a viable treatment option. The most common surgical procedure is a minimally invasive spinal fusion.
In spinal fusion, screws, rods and bone grafts are used to fuse the vertebrae together. Following the procedure, the patient will enjoy reduced pain, increased mobility and less reliance on pain medications.
Our surgeons also offer spinal osteotomy procedures as part of a spinal fusion to increase the spine’s flexibility. UH Rainbow is one of a limited number of specialized centers in Ohio that performs this procedure regularly in children.
- FIREFLY® TECHNOLOGY
Firefly® Technology uses specialized software to convert CT images into an exact, three-dimensional computer image of the patient’s spine. 3-D printing technology then converts the image into a model of the spine that surgeons can hold and study from all angles, enabling them to plan and practice their surgical approach.
Spine surgery often requires placing screws to correct and maintain the vertebrae’s position. As part of the preoperative planning, Firefly® also provides 3-D printed guides so that during surgery, the surgeon can insert these screws through preselected pathways. Knowing exactly where to insert the screws eliminates the need for image-guided navigation and greatly reduces radiation exposure to the patient. Firefly® also decreases the risk of spinal cord, nerve and tissue damage. The pediatric spine specialists at UH Rainbow were the first in Northeast Ohio to use Firefly® Technology.
- VATS PROCEDURE
Video-assisted thoracoscopic surgery (VATS) is a minimally invasive procedure. Benefits of the technique include less pain and faster healing.