Things to know about a scoliosis diagnosis

When parents learn that their child has scoliosis – curvature of the spine – they typically want to know how it was caused and how it can be treated.

Dr. Andrea Kramer, a pediatric orthopedic surgeon at Advocate Children’s Hospital, says most of the time the cause is unknown, although sometimes other medical conditions such as muscular dystrophy and cerebral palsy can contribute to developing it. The condition is most common in adolescents, especially girls, and is most often noticed by their pediatrician at their annual visit. Parents are more likely to notice that something is wrong during the summer, when kids are wearing bathing suits and it’s easier to see the curve in their spine.

“Parents may actually see the curve in their child’s spine. They may also notice that their child’s hips or shoulders are uneven – one hip or shoulder is higher than the other – or that one shoulder or set of ribs is slightly forward of the other due to the twisting in their spine,” Dr. Kramer says.

Once an X-ray is done to confirm a diagnosis of scoliosis, Dr. Kramer and the family begin to form a treatment plan, which is determined by the child’s age and severity of the curve. Many children with scoliosis have only a small curve in their spine. With a 20-degree or less curve, kids can be observed to make sure the curve doesn’t get worse and only need treatment if the curve becomes more severe or is causing pain. More severe curves are treated with a brace or surgery.

“Kids who are still growing and have curve of more than 25 degrees will have a brace,” says Dr. Kramer. “If the brace does not support them or the curve continues to progress past 45-50 degrees, surgery is often recommended.”

Dr. Kramer says bracing has come a long way over the years and isn’t the restrictive device it once was. Now, the brace can be hidden under clothes and worn 13 to 16 hours a day, including while sleeping. Kids take it off for all sports and activities, and Dr. Kramer stresses that the brace does not stop them from participating in the sports and activities they enjoy. While the brace won’t “fix” scoliosis, it will help keep the condition in check.

“The brace is meant to prevent progression. For example, if the curve is 25 degrees and never gets worse and doesn’t cause any problems or pain, that’s okay,” says Dr. Kramer. “The brace is only used when kids are growing, so diagnosing scoliosis early is key to getting this treatment.”

If the curvature worsens despite the brace, the curve is severe (greater than 50 degrees), or there is an increase in pain, Dr. Kramer says scoliosis patients are candidates for surgery.

“Surgery consists of a spinal fusion and is meant to stabilize the curvature and gain some correction,” says Dr. Kramer.

In addition to monitoring, wearing a brace or having surgery, Dr. Kramer recommends patients engage in a special form of physical therapy designed specifically for those with scoliosis called the Schroth method, which focuses on building core strength and posture training.

Parents who are concerned that their child may have scoliosis should have their child evaluated by a doctor.

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