Adolescent idiopathic scoliosis is the most common spinal deformity and affects children around the age of 10. Instead of growing straight, the spine curves sideways, leading to uneven hips, shoulders and waist. In this Q&A, Dan Hoernschemeyer, MD, chief of children’s orthopaedics at MU Health Care, discusses this problem and what parents should know about it.
What advice do you have for parents about scoliosis?
Parents should really keep an eye on their kids as they grow. You can typically notice a potential problem in girls between fifth and sixth grades and boys around sixth and seventh grades.
What should parents look for in their child to spot a problem with scoliosis?
Look for asymmetry. During the summer when kids are in bathing suits, it’s easier to notice something uneven about their back. You should be looking at the shoulders, the shoulder blades, whether ribs are higher on one side and/or a trunk shift where the body is shifted to one side.
What is the most important thing for parents to consider if scoliosis is present?
If a primary provider suspects scoliosis, it’s important to consult a doctor who specializes in the field of pediatric spinal deformity to assess if there’s any concern of the condition progressing.
Should there be a sense of urgency if a child has an issue?
If your primary care doctor says your child might have scoliosis, an examination and X-ray within four to eight weeks is recommended.
How can scoliosis affect lifestyle?
Mild scoliosis, with less than a 25-degree curve, doesn’t really cause any major impact on lifestyle. Generally, when the angle of the curve gets above 40-50 degrees, it will progress during adulthood at about a degree per year, and that could have an impact on lifestyle and pulmonary function down the road.
What are treatment options for scoliosis?
Treatment options depend on the age of the patient and the flexibility of the spine. If the patient has flexibility and has 25 degrees of curvature or less, then we would treat that child with a brace. If the spine has more than 45 degrees of curve but the child still has some growth ahead, that’s when we would talk about a new, less-invasive option called vertebral body tethering (which is not currently FDA-approved) to preserve flexibility. If the patient is done growing and has over 50 degrees of curvature, that’s when we would consider the traditional method of posterior spinal fusion, which has been around for decades.