What signs should a parent look for when checking a child for scoliosis?
The easiest thing to do is look at your child’s back to make sure their shoulders are level, that the shoulder blades look the same and that the head is centered over the child’s buttocks crease. Another thing you can do is have them bend forward and look for any type of asymmetries.
What are the different types of scoliosis that affect children?
The most common type of scoliosis that we see is called adolescent idiopathic scoliosis. This is for children who have no type of neurologic disorders or diseases and no connective tissue diseases. It is a genetic disorder that causes scoliosis. We don’t know quite how the genes work but we know there are about 300 genes that can cause scoliosis and depending on how many of these genes your child has determines whether or not they develop a curve and whether or not they will need to have surgery.
The second most common type of scoliosis we see is neurologic scoliosis, or paralytic scoliosis, where a child either with a type of neuromuscular disease, such as cerebral palsy, or they have had a type of injury that has paralyzed them.
What are the treatment options for children?
The first thing the child needs to do is be seen by an orthopedic spine surgeon who takes care of scoliosis. Once they have been seen by this surgeon they can decide whether or not they need to be followed clinically through regular check-ups, X-rays, bracing or if it will require surgery. We usually talk about bracing the child if the curve is between 25 and 30 degrees and we talk about surgery if the curve is between 45 and 50 degrees.
What should a parent consider before deciding on surgery for a child with scoliosis?
I think the most important thing is that they have a good relationship with their scoliosis surgeon, that they trust him or her and even look for a second opinion if they have any questions.
If a child with scoliosis goes untreated what health problems might occur as a result?
The child may have incapacitating back pain in the future and if the curve gets over 90 degrees they can develop heart failure which will require a heart or lung transplant.
The majority of kids who have scoliosis are pain-free. The prevalence of children who need surgery for scoliosis is more common in girls than boys. The nice thing to know is that kids that have scoliosis treated with a brace or those kids who are treated with surgery have completely normal lives in the future and usually are not limited on any activities.