Scoliosis: Is the Curve in Your Child’s Spine Normal?

Scoliosis is defined as curvature in the spine greater than 10 degrees. Scoliosis is a relatively common condition that causes the spine to curve and rotate into a C or S shape instead of a straight line. Curves greater than 10 degrees are seen in approximately 3% of the population. Curves that progress to greater than 30 degrees are more rare (0.3%). Many times what parents think is scoliosis turns out to be spinal asymmetry (a slightly curved spine) but for a small number of children, the severity of the curve in their spine may require treatment.

Early identification can help your child get the care they need – so here’s what you need to know about recognizing if your child may have scoliosis, its potential impact, and medical innovations that have changed the way that the condition is treated.

What causes scoliosis? Most cases (about 80%) are considered to be idiopathic, which means they don’t have any identifiable cause. However, sometimes curvature can be caused by underlying medical conditions such as spina bifida, muscular dystrophy, and traumatic spinal cord injuries. Congenital scoliosis develops before a baby is born and abnormal vertebrae (spinal bones) may appear alongside other deformities in the bladder, kidney or heart.

What are the symptoms of scoliosis? Children may appear to have uneven shoulders, shoulder blades or waistline, or appear to be leaning to the side when standing straight. Scoliosis typically does not cause back pain.

How is it diagnosed? Scoliosis can only be diagnosed using an X-ray, where physicians measure the exact degree of curve in your child’s spine. Anything more than a 10 degree curve is considered to be scoliosis. Curves with less than a 10 degree bend are diagnosed as spinal asymmetry – which generally doesn’t require any treatment.

What is the typical age for a child to be diagnosed with scoliosis? Scoliosis can develop in children from birth to adolescence, or at any point when the spine and skeleton are undergoing periods of rapid growth.  While mild scoliosis impacts an equal number of girls and boys, girls are more likely to develop progressive spinal curvature that require more aggressive treatment.

How is scoliosis treated? Treatment will depend on your child’s age, how curved their spine is and amount of growth still needed for your child’s bones to reach maturity. With mild cases of scoliosis physicians will typically take a wait and see approach. In more severe cases children will wear a customized brace or undergo surgery to fuse vertebrae together in order to prevent additional deformity.

Children whose scoliosis is progressing rapidly but still have an immature skeleton may be treated using devices that allow the spine to grow with the child.  MAGEC rods (magnetically controlled growing rods) are a type of distraction-based growing rod system that can be used to treat early-onset scoliosis. They are used to allow the surgeon to control the curvature of the spine and allow for growth of the spine to occur with a magnet that can be lengthened non-operatively in clinic.

Other forms of treatment can also be utilized such as traditional growing rods, or a Vertical Expandable Prosthetic Titanium Rib (VEPTR) device which supports the spine until fusion surgery can be performed.

Nationwide Children’s was the first hospital in Ohio to receive access to the VEPTR device, and less than 10 surgeons in the state are approved to implant the device. Neither physical therapy nor stretching has been shown to improve or stop scoliosis, although further research is being conducted to determine if non-surgical methods can be effective in improving or slowing down the curvature.

Is there anything that I can do to prevent scoliosis? No. But early diagnosis can be helpful in getting treatment that may reduce the degree of curvature in your child’s spine.

Most importantly, there is nothing about the condition that should limit their physical activity. Children should maintain a normal lifestyle and enjoy family, school and sport activities.

If you have questions or would like to request an appointment with one of the specialists at Nationwide Children’s, click here or call (614) 722-6200. For more information on scoliosis listen to our PediaCast.

Walter Samora, MD
Walter P. Samora, MD, is Director, Nationwide Children's Pediatric Orthopaedic Residency Program and a Clinical Assistant Professor of Orthopaedic Surgery at The Ohio State University. He received his medical degree from West Virginia University School of Medicine in Morgantown, West Virginia. After residency at West Virginia University he completed a Pediatric Orthopaedic fellowship at Nationwide Children's Hospital in Columbus, Ohio. He was recently named as one of the 2013 Emerging Leaders in Orthopaedics by the AOA. Primary clinical interests include conditions of the spine, sports related injuries and general orthopaedics. Dr. Samora is a board member of Recreation Unlimited. He is a member of the American Academy of Orthopaedic Surgeons, Ohio Orthopaedic Society and the Columbus Orthopaedic Society.

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