Idiopathic Scoliosis in Children

Category: Health

Idiopathic scoliosis only occurs in approximately 2% of children in the United States and although it is rare, it is important for parents and doctors to detect it early so observation and treatment can begin.   Without proper treatment this type of scoliosis can cause serious health problems for the patient later in life such as inhibiting the function of the lungs and heart.  It is important for parents to be aware of how to detect scoliosis so they can contact their child’s primary care physician if they feel their child is affected by this condition.

What is Idiopathic Scoliosis?

Idiopathic scoliosis is an abnormal curvature of the spine that can occur in the upper spine, the lower spine, or both.  In scoliosis, each vertebra of the spine can also twist, causing a corkscrew effect and causing the spine to twist inward and harm vital organs.   Scoliosis can begin in children between the ages of 8 to 12 and occurs in girls twice as often as it does in boys.  There is no known cause of this type of scoliosis, although researchers have found it can be hereditary in families.

Early detection of scoliosis is important because as a child ages, the spine hardens and is no longer flexible enough to treat.  Treatment for scoliosis is best done before a child finishes growing, generally by age 17 in girls and 18 in boys.

Detection

In most cases there are no warning symptoms of scoliosis such as back pain or lack of flexibility.  The best way to detect scoliosis is looking at your child in one of two positions.  With his shirt off, have your child stand and bend forward as if to touch his toes.  If one shoulder blade is higher than the other, or you can see an obvious curve in your child’s spine then you need to make an appointment with you child’s physician.  Another way to detect scoliosis is to have your child sit on the floor with his back straight while you look at his back.  If one shoulder is higher than the other, or one shoulder blade is more prominent than the other then your child may be at risk of having scoliosis.  Other signs that your child’s spine may be curved are if his head is off center when he is standing straight, if one hip is higher than the other or if he has an uneven step to his walk.  If you see any of these signs in your child you should make an appointment to see your family physician.

Your doctor will also examine your child and possibly take x-rays to estimate the extent of the curve of your child’s spine.  Whether the curve is small or significant, it is best to have your doctor refer you to a specialist who is familiar with the treatment of scoliosis.  A specialist will know best how to determine the proper treatment for your child’s condition.

Treatment

In 90% of scoliosis cases no treatment is necessary except for monitoring the child’s spine throughout his growth cycle.  However, there are many factors to consider when treating scoliosis.  Curves of the spine are measured in degrees, so the higher the degree of the curve, the more likely there will be treatment.  Other factors include the age of the child, the development stage he is in and the location of the curve.  Most spinal curves under the 25 degree range are generally safe and only need to be monitored, however if a child is prepubescent and still has many years of growth left the curve may worsen and treatment may be necessary.  Children with spinal curves that are over 30 degrees are candidates for bracing, while those who have curves in the 45 degree range or more should consider surgery.   If your child has a curve of over 45 degrees or if there is any question as to whether or not your child should have surgery you should ask the specialist to refer you to a surgeon for evaluation.  The surgeon is the only person who can evaluate your child’s candidacy for surgery and the longer you wait, the harder it will be for the surgeon to straighten your child’s spine effectively.  Knowing all of your options before beginning treatment is best for your child.

Bracing for scoliosis is different for each patient depending upon the severity of the curve and where it is located.  The point of bracing is to keep the spine in one position so the curve will not worsen as the child grows.  In most instances today, braces are worn from the chest down and can be easily covered with clothing.  The braces are made of molded plastic and are padded at strategic points.  They are generally worn 24 hours a day, although in some instances they can be worn only at night.  Once a child has gone through puberty and is no longer growing they can stop wearing the brace.

Surgery is used in only the most severe cases and has to be performed before a child has finished growing.  In most cases, surgery involves correcting the spine by fusing vertebrae together and inserting rods along the spine to hold it in place.  How straight your child’s spine will be after surgery depends upon how severe the curves are and how flexible your child’s spine is at the time of surgery.  Fusing the spine will keep it in place so your child will not have problems with the spine twisting inward and damaging the lungs and the heart later in life.

Diagnosing and treating scoliosis is important for your child to lead a healthy life.  Many school systems have a screening program for scoliosis, but if your school does not it is important that you check your child yourself or make an appointment with your child’s physician for a physical once a year.  Early detection and treatment will help save your child from having health complications as a result of scoliosis later in life.