Definition of Scoliosis

[SKOH-LEE-OH-SIS]

When children have scoliosis, it means their spine abnormally curves to the right or left side of the body. This spinal curvature can be moderate to severe.
While scoliosis is sometimes caused by conditions such as muscular dystrophy or cerebral palsy, the cause of most scoliosis is unknown (idiopathic). The spine can be curved in scoliosis at any part. The most common parts affected by scoliosis include the lower part of the back (lumbar scoliosis) and the chest (thoracic scoliosis).

When scoliosis occurs, the spine can curve several different ways:

  • Levoscoliosis: the spine has a single curve to the left and looks like the letter C.
  • Dextroscoliosis: the spine has a single curve to the right and looks like a backwards letter C.The spine curves twice, once to the left and once to the right, and looks like the letter S.

Scoliosis Signs & Symptoms

There may be signs and symptoms present that will help identify childhood scoliosis. Signs consist of things that other people, such as a parent or doctor, observe. Symptoms are things that the child feels and expresses.

FOR EXAMPLE, THE FOLLOWING SIGNS AND SYMPTOMS MAY INDICATE THAT A CHILD HAS SCOLIOSIS:

  • The child leans to one side.
  • Clothing does not hang correctly and evenly on both sides.
  • Head is not centered directly above the pelvis.
  • One shoulder blade is more prominent and higher than the other when viewed from the back.
  • One shoulder is higher than the other when viewed from the front or back.
  • Ribs on one side are higher than on the other side.
  • One hip sticks out more than the other.
  • One hip is higher than the other.
  • One leg seems longer than the other.
  • Shortness of breath or chest pain (severe cases).

WHEN SCOLIOSIS OCCURS IN BABIES, ADDITIONAL SIGNS AND SYMPTOMS MAY INCLUDE:

  • When laying down, the baby’s body may consistently curve to one side.
  • A bulge on one side of the chest.

Causes of Scoliosis

Idiopathic scoliosis (unknown cause) – in about 80% of cases the cause is unknown.

While scoliosis affects millions of children each year, it is often difficult to identify the causes. Idiopathic scoliosis, in which “idiopathic” means the cause of the scoliosis is unknown, occurs in about 80% of childhood cases.

More rare types of scoliosis may be caused by:

  • Birth defects that keep the spine from developing normally when the baby is in the womb (congenital scoliosis).
  • Infections of or injuries to the spine.
  • Neuromuscular conditions, such as muscular dystrophy or cerebral palsy.
  • Hereditary factors
  • Genes
  • Significant differences between the lengths of the legs
  • Other factors like poor posture, carrying backpacks, and exercise

Children with Scoliosis

It is estimated that scoliosis affects about 7 million children in the United States and occurs most often during the growth spurt just before puberty. Idiopathic scoliosis, which means the condition’s cause is unknown, is the most common type of scoliosis affecting children.

For most children, scoliosis treatment isn’t necessary, as the condition is usually painless and will resolve itself as the child’s spine continues to grow. However, a child with any degree of scoliosis should continue to be closely observed by a medical professional in case the condition worsens and necessitates treatment.

If treatment is required, a back brace may be sufficient. There is a small number of children with severe scoliosis, though, who will need surgery because the severity of their condition could lead to serious damage to the chest, heart, lungs, spine, or pelvis.

Scoliosis Risk Factors

While the causes of most cases of scoliosis are unknown, doctors have been able to identify some possible risk factors for the condition. Thankfully, most children will not experience pain from scoliosis and will eventually grow out of it. However, severe scoliosis does occur and it’s important to be aware of things that could increase your child’s likelihood of developing this condition:

  • Genetics – those who have a close relative with scoliosis have a higher risk of developing scoliosis themselves.
  • Gender – while both boys and girls develop mild scoliosis, girls have a much higher risk of the condition getting worse.
  • Age – the signs and symptoms of scoliosis are noticed most often during a child’s growth spurt just before puberty, although babies can also have scoliosis.

Solutions for Scoliosis

I am personally committed to providing unsurpassed scoliosis care to your child, and I’ll begin each appointment by listening to and fully understanding your concerns in order to develop the most appropriate treatment plan. As with all conditions, the way scoliosis affects each individual child is unique. Since the condition is often painless, some children can live a normal life without ever knowing they have scoliosis.

For those with more noticeable signs and symptoms, treatment options such as bracing may be used to prevent the spinal curvature from worsening. In the most severe cases, surgery may be needed in order to properly straighten the spine and prevent any further damage or abnormality.

The fusion surgical approach to correcting scoliosis is not ideal children who are still growing, because it makes large parts of the spine immobile. Advances in minimally invasive spine surgery (MIS) have led to a new surgical option called vertebral body tethering (VBT). This surgery enables the scoliosis to correct itself by slowing down growth on one side of the spine while enabling growth on the other, which eventually balances and straightens the spine. VBT has been found to fully correct scoliosis and this approach has many advantages over fusion surgery, including a much quicker recovery time.

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