Medically reviewed by Dr. Sami Mardam-Bey Wake Orthopaedics

What is scoliosis?

It’s really just an abnormal curve of the spine. It’s fairly common, and approximately 3% of children are diagnosed with a mild or small curve (greater than 10 degrees). Only 0.3% progress to having a much bigger curve (greater than 30 degrees).

What is the cause?

We don’t really know, but we do know it is related to the growth of the spine. Some babies are born with scoliosis, but the more common types develop after birth. Children are commonly predisposed and might have a very mild curve that progresses as they grow. Many times a parent or other family member has scoliosis. However, it might be much milder and may have gone undetected if it didn’t progress to cause noticeable problems.

At what ages do children develop scoliosis?

It can happen at any age. The most common is adolescent idiopathic scoliosis, which typically develops between ages 10 to 12 for girls and 12 to 14 for boys. During growth spurts, there can be rapid progression in the curve of a spine so it’s important to catch it as early as possible and closely monitor, manage or follow a treatment plan as needed.

What are the short and long-term concerns?

If a curve gets bigger and begins to distort the body, it can impair heart and lung function. That is why it is important to catch it and take steps to prevent the curve from progressing. If not properly managed and treated, the spine can also get stiffer as the curve gets bigger, which can lead to pain.

When and how are children screened for scoliosis?Pediatricians generally screen for it, and just before or during puberty is the most common time for it to be detected.

What are the symptoms?

Contrary to what many assume, scoliosis is not typically associated with pain for children. Instead, the symptoms are visible. You might see a difference in the symmetry of the waist or shoulders, or it may appear that the child is leaning to one side. Frequently parents will notice a change in the appearance of the back or shoulders over the summer or at times when they see their kids frequently in bathing suits. There might be a visible prominence on one side of the back. For example, one side of the back might sit higher than the other when bent over.

Can adults develop scoliosis?

Some people will get diagnosed as adults, but it was probably already there from childhood. Degenerative scoliosis due to bad discs in the back is another type that can become a problem as people get older.

What are the most common treatments?

• Bracing is the typical treatment if the curve measures greater than 20 to 25 degrees while the child is still growing. Bracing can slow or prevent progression and is typically worn for 16 to 20 hours a day until the spine stops growing taller, which can be as early as age 14 for girls or until around age 16 to 18 for boys.
• Physical therapy (specifically the Schroth Method) can be used in addition to bracing to try to slow or prevent the advancement of scoliosis. This treatment involves exercises that are tailored to each patient based on their spine curvature.
• Spinal Fusion Surgery can be effective in preventing continued progression of the curve. Basically, the bones of the spine have movement between them, but at the part where the curve is, a surgeon will fuse them together so they cannot continue to curve more.

“If your child is diagnosed with scoliosis, they might feel isolated and need to be reassured that they are not the only one,” said Dr. MardamBey. “Most likely there are other kids in their school and community who are working through the same thing.”

How is scoliosis treated if caught in babies or young children?

Infantile scoliosis can be treated with serial casting, which involves applying and changing a cast every 8 to 12 weeks, to help push or mold the curve of the spine. This can help prevent it from getting more severe or possibly eliminate the curve early in life. The cast works like a brace but cannot be removed until the next cast is applied.

Know the facts!

• Treatment when needed is key. If you can keep the curve on the smaller side, the risks long term of having back pain or back issues are no worse than others.
• Remember there is nothing you or your child could have or should have done to prevent scoliosis.
• Most children whose scoliosis is properly diagnosed and managed live active, normal lives.
• Bracing has evolved over the years, the types used now have better molds and are more streamlined for children to wear both day and night. It’s important to log those nighttime hours by sleeping in the brace.
• Children with scoliosis still play many sports.

“Children with scoliosis should definitely be active and get their exercise just like everyone else,” said Dr. Mardam-Bey. If they need to wear a brace, he recommends simply removing it for physical activities and sports. “Take a break from it and play!”

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Meet the Expert

Dr. Sami Mardam-Bey is a fellowship trained pediatric orthopaedic surgeon at Wake Orthopaedics. He received his bachelor’s degree from Princeton University and attended medical school at Duke University. His clinical interests are in both operative and non-operative treatments of conditions of the spine (scoliosis and spondylolisthesis) and hip (dysplasia and impingement, Perthes disease, and slipped capital femoral epiphysis). Dr. Mardam-Bey was a competitive swimmer from childhood through college. He enjoys taking care of young athletes and understands the challenges of caring for the unique injuries of growing children.

 

This article is adapted from our Families First Magazine. Interested in getting future issues of Families First delivered to your home? Subscribe here.