Severe scoliosis typically progresses with time, so your doctor might suggest scoliosis surgery to reduce the severity of the spinal curve and to prevent it from getting worse. The most common type of scoliosis surgery is called spinal fusion.
The doctor will initially take a detailed
medical history and may ask questions about recent growth. During the physical
exam, your doctor may have your child stand and then bend forward from the
waist, with arms hanging loosely, to see if one side of the rib cage is more
prominent than the other.
Your doctor may also perform a neurological
exam to check for:
Plain X-rays can confirm the diagnosis of
scoliosis and reveal the severity of the spinal curvature. If a doctor suspects
that an underlying condition — such as a tumor — is causing the scoliosis, he
or she may recommend additional imaging tests, such as an MRI.
Most children with scoliosis have mild curves
and probably won't need treatment with a brace or surgery.
Children who have mild scoliosis may need
regular checkups to see if there have been changes in the curvature of their
spines as they grow.
While there are guidelines for mild, moderate
and severe curves, the decision to begin treatment is always made on an
individual basis. Factors to be considered include:
Sex. Girls have a much higher risk of
progression than do boys.
Severity of curve. Larger curves are more
likely to worsen with time.
Curve pattern. Double curves, also known as
S-shaped curves, tend to worsen more often than do C-shaped curves.
Location of curve. Curves located in the
center (thoracic) section of the spine worsen more often than do curves in the
upper or lower sections of the spine.
Maturity. If a child's bones have stopped
growing, the risk of curve progression is low. That also means that braces have
the most effect in children whose bones are still growing.
Scoliosis braceOpen pop-up dialog box
If your child's bones are still growing and
he or she has moderate scoliosis, your doctor may recommend a brace. Wearing a
brace won't cure scoliosis or reverse the curve, but it usually prevents
further progression of the curve.
The most common type of brace is made of
plastic and is contoured to conform to the body. This brace is almost invisible
under the clothes, as it fits under the arms and around the rib cage, lower
back and hips.
Most braces are worn day and night. A brace's
effectiveness increases with the number of hours a day it's worn. Children who
wear braces can usually participate in most activities and have few
restrictions. If necessary, kids can take off the brace to participate in
sports or other physical activities.
Braces are discontinued after the bones stop
This typically occurs:
About two years after girls begin to
When boys need to shave daily
When there are no further changes in height
Severe scoliosis typically progresses with
time, so your doctor might suggest scoliosis surgery to reduce the severity of
the spinal curve and to prevent it from getting worse. The most common type of
scoliosis surgery is called spinal fusion.
In spinal fusion, surgeons connect two or
more of the bones in the spine (vertebrae) together, so they can't move
independently. Pieces of bone or a bone-like material are placed between the
vertebrae. Metal rods, hooks, screws or wires typically hold that part of the
spine straight and still while the old and new bone material fuses together.
If the scoliosis is progressing rapidly at a
young age, surgeons can install a rod that can adjust in length as the child
grows. This growing rod is attached to the top and bottom sections of the
spinal curvature, and is usually lengthened every six months.
Complications of spinal surgery may include
bleeding, infection, pain or nerve damage. Rarely, the bone fails to heal and
another surgery may be needed.
Preparing for your appointment
Your child's doctor may check for scoliosis
at a routine well-child visit. Many schools also have screening programs for
scoliosis. Physical examinations prior to sports participation often detect
scoliosis. If you are informed that your child might have scoliosis, see your
doctor to confirm the condition.
What you can do
Before the appointment, write a list that
Detailed descriptions of your child's signs
and symptoms, if any are present
Information about medical problems your child
has had in the past
Information about the medical problems that
tend to run in your family
Questions you want to ask the doctor.
What to expect from your doctor
Your doctor may ask some of the following
When did you first notice the problem in your
Is it causing your child any pain?
Is your child experiencing any breathing
Has anyone in the family been treated for
Has your child grown rapidly during the past
Has your child started menstruating? For how