The Scoliosis Research Society estimates that more than 80 percent of scoliosis cases don’t have an identifiable cause. In addition, 90% of all cases of scoliosis occur in the adolescent and teenage age group ( > or = to 10 years of age) and possible explanations may include a fast growth spurt, neurological abnormalities, genetic conditions, or birth defects. tells us that 3 in 100 people develop scoliosisand that girls are more prone to developing severe cases of scoliosis than boys. Many cases of scoliosis in children are mild, so your child may not need any additional treatment.

If treatment is indeed indicated, back braces are an option for children. Your child may have to use a brace if:

• He or she is still growing and the curvature is more than 25 to 30 degrees.
• He or she is still growing and the curvature is between 20 and 29 degrees, but the curvature is getting worse.
• The curvature is between 20 and 29 degrees and he or she has at least two more years to grow; also if your child is a girl, and has not begun menstruation (NIAMS).

The curvature of the spine’s natural urge to continue to curve can be prevented by wearing a brace. This method of treatment is more effective for cases that are detected early. Bracing effectiveness is related in large part to the amount of time the brace is worn. Most studies indicate that optimal brace effectiveness is achieved when the brace is worn on average 18 hours/day. In unruly curves it may be necessary to increase brace wear to 23 hours per day to optimize the benefit.

You may be wondering what these braces look like and how will it affect your child’s self-esteem. There are two main types of braces:

• Underarm Brace: This brace is the most common type and is called a TLSO (thoracic-lumbar-sacral-orthosis) brace. This is a low-profile brace, which means it comes up under the arms and fits beneath the clothes. The TSLO brace is constructed of plastic and fits close to the body. This type of brace is practically invisible.
• Milwaukee Brace: This type of brace begins at the neck, covers the child’s entire torso, excluding arms and legs. The Milwaukee Brace is designed to treat the curves that an Underarm brace cannot.
• Charleston brace: This is also a low-profile brace, and it bends the spine to straighten the curve as much as possible to prevent the curve from worsening. This brace puts the child’s body in an awkward position, though, so it can only be worn while sleeping.

Surgery is generally considered a last resort treatment and is reserved for children with severe curves, which are greater than 45 or 50 degrees. If you feel that your child is experiencing too much discomfort or the curvature is interrupting your child’s daily life, talk to your doctor.

Want more information about scoliosis in children? Read Dr. Baynham’s educational Scoliosis Information section on the Children Scoliosis website.

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