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Scoliosis can be a frightening word for parents and kids, but it doesn’t have to be.
Experts say being able to spot the signs and learning about various treatments for scoliosis—a curvature of the spine—helps empower parents to make the right decisions for their kids.
“People can lead absolutely normal lives. It’s not a scary thing to be diagnosed with scoliosis,” says Jason Lowenstein, MD, director of Scoliosis and Spinal Deformity at Morristown Medical Center and a partner at the Advanced Spine Center in Morristown. “The earlier we figure it out, the better.”
But first parents and caregivers need to understand the basics of scoliosis. It’s typically a painless condition that tends to appear more often in girls than boys and can lead to serious problems if left untreated.
Mark A. Rieger, MD, director of The Scoliosis Center, a division of Advocare The Orthopedic Center in Cedar Knolls, describes scoliosis as an asymmetry of the spine. “The spine should be like a staircase going up and down,” says Rieger, an assistant professor of Orthopedics at NYU Langone Medical Center. “Scoliosis looks like a spiral staircase.”
Spotting the signs of scoliosis can be tricky since it tends to show up in kids older than 10 when they’re becoming more modest about their bodies around about their others. “It’s very, very difficult for parents to notice any difference in the spine,” says Rieger. “That’s why school screenings and annual check-ups are so important.”
Adolescent growth spurts can also present challenges. “It’s common for scoliosis to seemingly show up over a few short weeks,” says Daryl Antonacci, MD, chief spine surgeon and director at the Institute for Spine & Scoliosis, which has offices in Lawrenceville and Manhattan.
Antonacci points out that dance teachers and coaches may be more likely to spot the signs, like uneven shoulders and hips. One shoulder blade may be more prominent, creating a “hump” when a child bends forward. One hip may also stick out more than the other. “Parents should always trust their instincts and insist on an evaluation,” Antonacci says.
Scoliosis can run in the family, but there aren’t any proactive measures parents can take. “Parents tend to ask what they could’ve done to prevent scoliosis,” Paul Sponseller, MD, chief of the Division of Pediatric Orthopaedics at the Johns Hopkins Children’s Center in Baltimore, MD, says in an interview on the hospital’s website. “But scoliosis is a very interesting disease because there is currently no known cause or prevention method.”
If you think your child may have scoliosis, you should head to a specialist for X-rays to help determine the severity of the curve. Doctors factor in the child’s age and bone maturity before planning the next course of treatment. Treatment options generally fall into three categories, says Lowenstein. “You observe scoliosis, you brace scoliosis and if the curve is severe enough, you operate,” he says.
If doctors decide a patient should be monitored, the child will probably need X-rays on a regular basis. This hits close to home for Rieger, whose daughter was diagnosed with scoliosis as a child. “I’m the parent who always worried about my child getting radiation,” he says. His office just started using a state-of-the-art low dose X-ray imaging machine known as an EOS.
Rieger says certain types of physical therapy can slow progression of the spinal curve and make back braces more effective. But asking a kid to wear a back brace is daunting for most parents, many of whom may remember the teen protagonist Deenie in the Judy Blume book of the same name, or Joan Cusack’s character in the film Sixteen Candles. Both struggled with the bulky devices.
The good news is braces are slim and form-fitting now. But kids and teens will likely still balk at the idea of wearing them all the time. “There’s a tremendous amount of research that shows bracing is very effective,” says Lowenstein. “But it’s very much dose-dependent. A brace will be more effective if you wear it 18 hours a day rather than eight.”
The inconvenience of wearing a brace for extended periods pays off. “Bracing is over 90 percent effective in avoiding progression of the curve to the point of surgery,” Rieger says. If the curve is severe enough, doctors will discuss surgical options with a child’s parents.
Surgeons will try minimally invasive surgery if possible. There are several different procedures to correct scoliosis, which can include the use of screws and fusion to straighten the spine. It’s vital to get a second and third opinion (or more) to make sure the procedure is right for your kid.
“Treatment options have significantly changed in the past 10 years, and metal rod fusion is no longer the only option for even severe cases,” Antonacci says. “So early detection and getting multiple orthopedic opinions is important.”
Rieger encourages families to speak with previous scoliosis patients and their parents about their personal journeys and treatments. “They might not believe me, but they will believe the patient who has gone through the experience,” he says. “When they hear from them, they feel much better.”