Pediatric Scoliosis
It’s difficult for any parent to learn that their child has scoliosis, and this news can become even more challenging to process if surgery is mentioned as a possible treatment option. But here at the Westfield Orthopedic Group, we take every measure to address any fears or concerns parents may have by providing education about pediatric scoliosis and explaining that most children will not need surgery. And in the rare cases when surgery may be considered, our board-certified orthopedic surgeons Dr. Shaw and Dr. Krell will walk you through all the steps, benefits, and potential risks involved, so you know exactly what to expect.
A brief overview of the spine and scoliosis
The spine is a column of small bones called vertebrae that support and stabilize the entire upper body. These vertebrae are grouped according to their location in the spine, starting with the cervical (neck) and followed by the thoracic (mid-back) and lumbar (lower back) regions. Below the lumbar spine are two more groups of fused vertebrae called the sacrum and coccyx (tailbone).
A normal, healthy spine features several curves that can only be noticed if you were to look at your spine under an X-ray from the side. The thoracic spine and sacrum each have an outward curve, while the cervical spine and lumbar spine each have an inward curve. These curves create the general shape of your spine and serve essential functional purposes by carrying your upper bodyweight and providing you the flexibility needed to bend, twist, and rotate your spine in so many directions.
Scoliosis is a condition in which there is abnormal, sideways curvature of the spine. This means the spine of scoliosis patients has one or more curves that can be visible when viewed from behind. Scoliosis is fairly common, affecting up to 3% of the population and about 9 million Americans. It can occur at any age but is most likely to develop during puberty between the ages of 10–18 years, and it’s the most common spinal deformity in school-age children. Although scoliosis can be caused by several diseases—like cerebral palsy and multiple sclerosis—most children have idiopathic scoliosis, which means no clear cause has been identified.
Understanding treatment options for pediatric scoliosis
If your child is diagnosed with scoliosis, it’s important to understand that there many treatment options are available. Determining the most appropriate course of action depends on several factors, particularly the child’s age, the severity of the curvature, and at what stage scoliosis has been detected.
Most cases of scoliosis begin mildly and do not cause pain or interfere with patients’ movements. Doctors grade the severity of scoliosis by the angle of the spine’s curvature, and cases are considered mild when this angle is between 10–20°. Experts typically recommend only careful monitoring of these smaller curves to see if they progress further.
If the curve progresses into the range of 20–40° or the patient initially presents with this degree of curvature, a more active treatment approach will be needed. Nonsurgical interventions are still recommended for most cases at this stage, with bracing and various forms of exercise representing the two most common treatment approaches. Although neither bracing nor exercise can correct the curvature of the spine, these interventions can help patients move with greater flexibility and may prevent further progression of the spinal curvature.
Advanced scoliosis is when the curvature of the spine is 45° or greater. For children with advanced scoliosis and those in which the curvature is still progressing even with nonsurgical interventions, surgery may be considered because additional progression could lead to future heart or lung complications. Bear in mind that these cases are rare, as less than 10% of children and adolescents with idiopathic scoliosis will require surgery.
If surgery is considered, Dr. Shaw or Dr. Krell will carefully explain which procedure is recommended and how it will slow or correct your child’s spinal curvature. There are several surgical techniques that can be used for pediatric scoliosis, but two of the most common are spinal fusion and growing rod techniques:
Spinal fusion surgery
- Most frequently utilized surgical procedure for pediatric scoliosis
- Reserved for older children, usually in the teenage years
- Involves combining (fusing) two or more vertebrae with metal rods or other devices to stabilize the curved part of the spine or correct the deformity
- In-situ fusion is typically used for moderate curves, while spinal fusion with corrective instrumentation is typically used to correct more severe deformities
Growing rod techniques
- Can be performed on younger children (usually under 8 years)
- Involves the attachment of special, expandable devices called growing rods to the child’s spine or ribs
- Every six months or so after the initial procedure, these rods are lengthened a small amount to facilitate the child’s growth
- When the child’s spine reaches its maximum length, the rods are removed; spinal fusion may be needed at this time to further straighten and stabilize the spine
Learn more about pediatric scoliosis at the Westfield Orthopedic Group
At the Westfield Orthopedic Group, we understand that even the prospect of surgery for your child can be overwhelming, but our orthopedic surgeons and staff are here to support you at every step along the way. For more information or to schedule an appointment, call us at 908-232-3879 or fill out an appointment request form.