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Scoliosis (Idiopathic, Neuromuscular and Congenital)
Gillette Children’s Specialty Healthcare is one of the nation’s Best Children’s Hospitals in pediatric orthopedics. Our orthopedic surgeons are known internationally for their expertise in treating pediatric spine conditions, including scoliosis.
We offer comprehensive scoliosis evaluations, treatments and services for infants, children, teens and adults. We offer a family-centered environment that helps our patients achieve their highest possible levels of health, independence and happiness.
Why Choose Gillette?
- Gillette is one of the nation’s Best Children’s Hospitals in pediatric orthopedics.
- We are the regional leader in providing comprehensive specialty health care for patients who have scoliosis.
- Our facilities and technology are designed specifically for people who have scoliosis and other complex conditions.
- Gillette is the first hospital in the region to use FDA-approved magnetically controlled growing rods (MageC®) for children who have early onset scoliosis.
- We offer fellowship-trained surgeons and an interdisciplinary team of experts who understand how scoliosis affects health, appearance, self-esteem and quality of life.
- We manage many types of scoliosis—from idiopathic scoliosis that affects otherwise typically developing teens to neuromuscular scoliosis associated with conditions such as cerebral palsy, muscular dystrophy or other neuromuscular conditions.
- We believe that children who have scoliosis deserve a lifetime of excellent health care—from birth through adulthood.
Definition and Types of Scoliosis
Scoliosis is an abnormal lateral (side-to-side) curvature of the spine. The spine of a child with scoliosis might resemble an “S” or a “C” rather than a straight line.
There are several types of scoliosis, each with varying degrees of severity:
- Congenital scoliosis: This relatively rare form of scoliosis is present at birth.
- Juvenile scoliosis: Another uncommon form, this type develops during childhood.
- Idiopathic scoliosis: The most common form, idiopathic scoliosis (also called adolescent scoliosis) develops during adolescence and accounts for 85 percent of all cases.
- Neuromuscular scoliosis: This type of scoliosis develops as a result of abnormal muscles or nerves; it occurs in people who have conditions such as spina bifida, cerebral palsy or muscular dystrophy.
- Degenerative scoliosis: This form typically develops later in life as joints in the spine wear down or develop osteoporosis, but it can result from injuries or previous back surgery.
Scoliosis Incidence and Risk Factors
Research shows that the most common type of scoliosis (idiopathic, or adolescent, scoliosis) frequently runs in families. Evidence suggests that genetics play a role. However, some children with scoliosis have no relatives with the condition; in such cases, the cause is unknown.
Adolescent scoliosis occurs after age 10, and its prevalence is relatively similar for boys and girls. Girls, however, are much more likely to have larger curves and/or curves that will progress. Larger curves require monitoring and possible treatment with bracing or surgery. Three to five of every 1,000 children develop spinal curves that are large enough to require treatment.
Left untreated, scoliosis can worsen. In addition to curving, the spine can begin to rotate, contributing to diminished lung capacity and heart problems. That’s why early detection is so important.
If curves in the spine are going to progress, they often do so during growth spurts. On average, girls start their peak growth spurt at 11.5 years of age; it lasts about 24 to 36 months, until the spine stops growing. It’s important to identify potentially troublesome curves at this point, before the spine fully develops.
Children and teens with a family history of spine problems should receive regular checkups from their primary care providers. Although scoliosis screening isn’t required statewide, many schools conduct scheduled screenings. School nurses may screen girls in fifth and sixth grade. A positive screening doesn’t necessarily result in a scoliosis diagnosis. In such cases, however, it’s important to obtain an evaluation from an expert in childhood spine deformities.
Providers look for a variety of clues indicating that a child has scoliosis. They include:
- Asymmetry (inequality from side to side) of the spine, shoulder or shoulder blade areas
- Oblique (twisted) pelvis
- Signs of an underlying spinal defect, including café au lait spots, hairy patches, dimples and spinal masses on the skin
- Trunk rotation when the child bends forward
- Unequal distances between the arms and sides of the body when a child stands upright or bends forward
- Uneven waistline
Any infant, child or teen suspected of having scoliosis should undergo a formal evaluation by a qualified specialist, who will likely obtain spine X-rays and possibly other imaging tests, such as magnetic resonance imaging (MRI) of the spinal cord. Early detection increases the likelihood of managing scoliosis without surgery.
Care and Treatments for Scoliosis
Gillette physicians have revolutionized many treatments for spine disorders, including scoliosis. We have developed effective spinal orthoses (braces) and surgical techniques that reduce hospitalization and recovery time and lessen the need for additional surgeries as children grow.
The primary goal of any treatment is to avoid progression (worsening) of the curve by evaluating the curvature early and managing it conservatively. In many cases, surgery will be unnecessary if patients receive proper care and follow their care providers’ instructions for bracing.
Treatment of scoliosis varies depending on a patient’s age, the degree and pattern of spinal curvature, and the type of scoliosis. Treatment options include:
- Regular examinations, every four to six months, during growth for skeletally immature children who have mild to moderate curves
- Bracing for skeletally immature children who have more severe curves; braces don’t cure scoliosis, but they can prevent it from worsening
- Spinal fusion surgery for children who have severe curves
- Vertical expandable prosthetic titanium rib (VEPTR) surgery for the rare cases in which children have severe curves that cause thoracic insufficiency syndrome (inability of the chest to support normal breathing or lung growth)
- Magnetically-controlled growing rods (MageC®) for children who have early onset scoliosis, if bracing was ineffective. The implanted expandable rods act as internal braces to control curve progression while allowing normal skeletal growth. The rods can be lengthened during outpatient visits with a noninvasive remote controller.
To date, there is no evidence that alternative forms of treatment, such as chiropractic care or physical therapy, can alter the progression of or improve scoliosis. However, many children receive physical therapy services to address related conditions, such as weak abdominal or back muscles or muscle tightness. Because the position and stability of the spine changes with growth, children often need evaluations and care by an orthopedic surgeon throughout their growing years.
For more information about the treatments we offer at Gillette, search Conditions and Care.
Our Scoliosis Services
Patients who have scoliosis range from otherwise healthy children with minor curvatures to children with complex underlying conditions. At Gillette, we provide a full range of services and highly trained experts to manage spine conditions ranging from mild to severe.
Specialties and services most often involved in scoliosis care include:
- Pulmonology and respiratory care
- Rehabilitation therapies
- Seating and mobility equipment (for children, teens and adults who have neuromuscular scoliosis associated with conditions that limit their ability to walk)
For more information about the comprehensive services we provide at Gillette, search Conditions and Care.