PEDIATRIC SCOLIOSIS

More often than not, children with scoliosis can be treated with a brace, but in cases where patients have an increase in their curve and are in pain, the doctors may suggest surgery.

SWSI Pediatric Scoliosis Quiz

There are a small number of doctors who specialize in scoliosis surgeries in the United States.Drs. Richard Hostin, Kathryn Wiesman, and Shyam Kishan have been treating pediatric scoliosis for more than 40 years.

Pediatric Scoliosis – Treating Children through Adulthood

Pediatric Scoliosis child playing with Airplane

In many cases, children with scoliosis can get treated with a brace, but in cases where a patient’s curve increases with pain, doctors may suggest surgery.  Doctors classify scoliosis as a  condition that can lead to severe deformity if not treated.  Diagnosing this condition early enables treatments that can make a big difference.

The Southwest Scoliosis Institute is one of the leading centers for pediatric spine care. We offer cutting-edge techniques for children with early-onset scoliosis, infantile scoliosis, and other conditions in the spines of children.

What Causes Scoliosis?

Doctors know the cause of many types of scoliosis and can pinpoint the cause to spinal birth defects, cerebral palsy, and injuries or infections of the spine. However, doctors do not know the cause of idiopathic scoliosis.

Symptoms of Scoliosis in Children

Signs of scoliosis usually get noticed in the preteen years and it occurs more in girls than boys. Parents may detect a fullness on one side of the child’s back when he or she bends over. They may also notice that the child’s clothes don’t hang properly.

Some of the signs of scoliosis in children include the following:

  • A more prominent shoulder blade
  • A shoulder blade appears higher than the other
  • The head does not align perfectly with the rest of the body
  • A curve in the spine or middle of the back
  • When the child bends forward, one area of the back appears higher than the other
  • Uneven hips
  • Uneven waistline

Pediatric Scoliosis — Complex and Rare

Children with cerebral palsy have the potential to get scoliosis during their early years. Pediatric scoliosis is closely related to the severity of cerebral palsy and often continues progressing after the skeletal system has matured. Although we know the actual cause of certain types of scoliosis, the following conditions can increase the risk of developing scoliosis:

Age

Scoliosis can occur at any age. However, it usually happens between 9 and 15 years.

Gender

Males and females usually have mild scoliosis at about the same rate. However, females are about five times more likely to develop severe spinal curves that require treatment.

Genetics

Since scoliosis runs in families, scientists and doctors believe genetics may cause the condition. Our doctors report that school-age children suffer from Scoliosis more than any other spinal condition. About 3 million new cases of this condition get diagnosed every year in the United States. Most of those diagnosed suffer from adolescent idiopathic scoliosis. Doctors perform about 29,000 surgeries on children from 11 to 18 every year in the United States.

There are different types of scoliosis affecting children:

  • Infantile idiopathic scoliosis: This type affects children between 0 and 3 years.
  • Juvenile idiopathic scoliosis: This type affects children between 4 and 10 years.
  • Adolescent idiopathic scoliosis: This type affects children between 11 and 18 years.
  • Congenital scoliosis: This occurs when the spine fails to develop properly in the womb.
  • Neuromuscular scoliosis: This type of scoliosis occurs because of a disorder in the brain, spinal cord, or muscular system.
  • Syndromic scoliosis: This type of scoliosis develops as a result of an underlying disorder like muscular dystrophy and Marfan syndrome.
  • Idiopathic scoliosis: relates to a type that doctors and medical researchers do not know the cause.
  • Early-onset scoliosis; a form of scoliosis that gets detected in children below the age of 10.

Early Diagnosis is Important

If you want your child to have the best outcome, an early diagnosis becomes important.  If scoliosis is detected before the child develops a growth spurt, it is easier to determine the treatment plan that will prevent a bigger curve while the child continues to grow. As a result, parents need to closely examine their children and if they become suspicious or see any signs they should make an appointment with a scoliosis doctor at the Southwest Scoliosis Institute.

Pediatric Scoliosis Screening

School health screening often helps to identify scoliosis, and we want to see those patients as soon as possible.  Once seen, bracing could be suggested.  The sooner it gets used the sooner improvement will occur. Most children with scoliosis do not need complex treatments, but they need at least two routine exams per year by a Scoliosis doctor. Most often, we assure parents that we either need to observe their child for four to six months or that the risk of the curve growing does not exist and that they don’t need to come back. In the event the child does need treatment, we will discuss the options with the parents.

Diagnosis

Sometimes Doctors find diagnosing scoliosis in young children difficult. In some cases, spinal curves stand out, but sometimes they do not appear because of a very slight curve. Our doctors find that parents will ignore scoliosis symptoms until the early puberty stage when children experience rapid growth. Since early diagnosis constitutes an important part of treatment, parents should check children and pre-teens regularly for signs of a spinal condition.

X-Rays

The X-ray remains the primary tool for diagnosing scoliosis. Doctors see spinal curves by looking at the child’s back, but an X-ray will allow a doctor to verify his visual exam and see the spinal column clearly to determine the degree of the curve.

The technicians will take the X-rays from the child’s back. They may also get taken from the side in some cases. The doctor may also request an EOS X-ray that takes mages with a lower amount of radiation. Magnetic resonance imaging (MRI) may also take images.

In addition to taking X-rays, the doctor will also obtain the full medical history of the child. The doctor will also carry out a detailed physical exam to detect numbness, muscle weakness, and abnormal reflexes.

The Exact Cause of a Certain Type of Scoliosis

Parents that discover that their child has scoliosis often blame themselves for their child’s condition. You don’t need to blame yourself. The exact cause of certain types of scoliosis is still not known. The heavy backpack they carry to school did not cause the condition. As a result, a parent cannot prevent the condition from developing. Although scoliosis runs in the family, a child might be the first member of a family to develop it.

Only Some Forms of Pediatric Scoliosis Require Treatment

A scoliosis diagnosis can be scary and will cause parents to ask lots of questions. We like those questions as the more you know about the condition, the less you will worry.  We want you to know that we treat scoliosis very successfully. Most children diagnosed with scoliosis will not need treatment.  For some serious cases, treatment will involve a brace, and then only a very small percentage will require surgery.

People with a 15-degree or less spinal curve may find that their small curve will not grow over time.  A child that has a 20 to 40-degree spinal curve (and still has 2 more years of growth) will wear a brace as a form of treatment.

Patients that have at least a 50-degree curve will most likely require surgery to treat the condition. The standard method for correcting such conditions is spinal fusion. Other treatments may also include growing rods, anterior vertebral body tethering, or surgery with fusion.

How to Determine a Treatment Plan

A scoliosis doctor will determine your child’s treatment plan by considering the results obtained from the child’s physical exam, X-rays, and the following factors:

  • The age, health, and medical condition of the child
  • Extent of curvature
  • The type of scoliosis the child has
  • The child’s tolerance for a particular treatment method
  • Parental Opinions
  • The course of the specific case

The main goal of a pediatric scoliosis treatment plan stops the curve from growing and corrects the existing spinal curve. If children with moderate or severe cases of scoliosis do not receive proper treatment, the curves will increase by one degree every year or every growth period. Without treatment, a child will develop a deformity, and may find it difficult to breathe if the rib cage compresses against their lungs and heart.

Pediatric Scoliosis Treatment

Not all children diagnosed with scoliosis require treatment. For mild scoliosis cases, our pediatric spine specialists help prevent the condition from getting worse or leading to uneven hips, rotating spine, breathing problems, and other complications. In situations of mild scoliosis where the doctors do not recommend any treatment, your child should get examined by a spine specialist every six months, especially when the child experiences rapid growth.

Most patients with mild curves, especially children with idiopathic scoliosis, do not need any treatment. However, they need a doctor to examine them on a routine basis. Pediatric scoliosis treatment comprises both surgical and non-surgical options. Non-surgical treatment focuses on preventing the curve from worsening. It also involves cosmetic improvement.

Observation

Many children do not require surgery or a special brace for scoliosis treatment. Furthermore, children, in particular, need a doctor to examine them before and during their growth spurts to identify any changes in their curves.

For instance, our practice uses the advanced EOS 2D/3D imaging system. This system provides high-quality X-ray images while delivering 50% to 85% less radiation than traditional digital X-ray systems. Also, reducing the dose of radiation becomes very beneficial for children who require frequent imaging. In this case, we know that children are sensitive to the effects of radiation and we do everything in our power to avoid excess.

Scoliosis brace

For large curves in children or curves that progress, we commonly recommend a scoliosis brace. In many cases, a brace can reduce the chance of a curve growing bigger and needing surgery.

Physical therapy

While not shown to alter the rate of a curve growing in either adults or children, exercise programs often help improve back pain.

Emotional support

Children with scoliosis may become conscious of their posture and appearance when they wear a back brace. When children do not want to let others see them with a brace, a support group may help in dealing with these self-image problems.

Alternative Pediatric Scoliosis Treatment

According to the Scoliosis Research Society, chiropractic medicine, yoga, physical therapy, and other treatments for preventing the spinal curves from growing do not result in any scientific role in treating scoliosis.

Pediatric Scoliosis Surgery

Non-surgical treatments may not work in some cases. In such a situation, surgery becomes the best choice to correct the curve. Factors that determine if a child needs scoliosis surgery include:

  • The severity of the curve. (curves greater than 45 to 50 degrees classify as severe)
  • The rate at which the curve grows
  • A child’s age, and
  • The symptom and overall health condition of the child

The surgeon may either use growth rods or carry out a spine fusion. Doctors can perform scoliosis surgery on children in many different ways. Most patients want to avoid surgery; but if scoliosis does not get treated, a growing spinal curve can affect the lungs and heart.

More often than not, children with scoliosis can get treated with a brace, but in cases where patients experience an increase in curvature and pain, doctors will suggest surgery. When surgery occurs, it requires a complex, multi-step procedure that takes between two and three hours. When a child needs scoliosis surgery to correct his or her condition, we can attend to those needs quickly and with the skill and precision of decades of experience.

Surgical Procedures

The child will receive general anesthesia for most traditional scoliosis surgeries. He or she will also stay in the hospital for some days to recover from the surgery. The child may also need physical therapy. Depending on the specific surgical procedure used, children can return to school after 1 to 6 weeks.

Vertebral Body Tethering

One of our advanced pediatric procedures refers to Vertebral Body Tethering Surgery.  Dr. Shyam Kishan is trained in the tethering procedure, which is a fairly new Scoliosis correction technique. With this procedure, fusing vertebrae is not needed and this allows motion in the spine and less scaring.This is a minimally invasive procedure whereby the surgeons will have access to the spine through different small incisions. The surgeons will then attach a special rope to different vertebrae and pull the rope tight. This straightens the spine and guides the future growth of the spine. This surgical approach prevents the child from spinal fusion later on.

Spinal fusion

Under this procedure, the surgeons will stabilize the spine with rods and pins (or screws). They will then fuse two or more vertebrae so that the curve can stop progressing while decreasing the current curve. Here at Southwest Scoliosis Institute, we use the least invasive techniques to help your child recover quickly with fewer complications.

Spine osteotomies

Doctors select this procedure for severe cases of scoliosis. In this procedure, the surgeons will remove some of the bone in the spine to correct the spinal deformities. Depending on the amount of bone removed, this procedure takes at least a couple of hours.

Shilla growth procedure

This procedure involves fusing a short portion of the spine and placing rods above and below the curve to correct it. This helps the spine to grow naturally. The procedure lasts between 4 and 6 hours. If necessary, follow-up surgeries may be required to either remove or replace the system.

Vertical Expandable Prosthetic Titanium Rib (VEPTR)

Doctors use This system for kids that are finding it difficult to breathe as a result of scoliosis. The procedure involves attaching expandable curved rods to the spine to straighten the spine and separate the ribs. This aids the growth and expansion of the lungs. As the child grows older, the VEPTR system can either be widened or narrowed as the need arises.

MAGEC growing rods

Magnetic Expansion Control rods (MAGEC) are used for kids that need different surgeries as they grow older. The rods are lengthened using an external magnetic motor which is placed on the child’s back. This procedure is non-invasive and it is repeated every 3 to 6 months for 3 years.

Why Choose Southwest Scoliosis Institute?

Southwest Scoliosis Institute has a team of board-certified doctors and highly experienced and trained specialists from different disciplines to give your child the care he or she needs to return quickly to the activities he or she loves.

Our team for treating pediatric scoliosis includes:

  • Board-certified orthopedic surgeons
  • Registered nurses that specialize in orthopedics
  • Orthopedic specialists
  • Advanced practice nurses and physician assistants who are committed to care
  • Physical and occupational therapists
  • Medical imaging experts

Our board certified orthopedic nurses provide the best care to obtain the very best results. In addition to these, there are other reasons why you should use our pediatric scoliosis treatment service for your child:

Latest technology

One of the most difficult areas of treating scoliosis is determining the patients that will progress to a severe condition and require treatment. Being able to predict scoliosis progression at an early stage improves treatment and makes it safer, more patient-friendly, and more effective. Our scoliosis doctors provide the best and latest scoliosis treatments for children, including a series of minimally invasive scoliosis surgeries.

Personalized care

We focus on providing professional pediatric scoliosis treatment to keep your child active and healthy. In addition to providing the best form of treatment possible, we are ready to answer any and all questions you have at any point during the treatment and encourage parents to learn as much as possible about your child’s scoliosis.

Experienced and reliable expertise

The Southwest Scoliosis Institute’s pediatric treatment program involves services for pediatric spinal disorders. As an institute with several specialists, our expertise comes from years of experience and a solid root in scientific and medical knowledge. We apply research-based care to every patient we treat.

We understand that you want to make the most informed decisions for your child’s scoliosis treatment. Because of this, we will give you the details you need to know about your child’s scoliosis so that you can have the information you need.

Low-radiation imaging

We use a low-radiation imaging system wherever possible. This limits the amount of radiation that your child is exposed to if X-rays will be taken throughout the years to come.

Team of experienced specialists

Our pediatric scoliosis doctors have advanced training and expertise in diagnosing and treating several types of scoliosis in kids. Our team of neurosurgeons, orthopedic surgeons, anesthesiologists, pediatricians, neurologists, and physical therapists will provide the care your child needs to be active again.

The dedicated pediatric intensive care unit at Medical City Hospital will cater to your child’s well-being and will also help your child understand what to expect. Our support staff will also help your child recover quickly with no complications.

Commitment to advanced scoliosis care

Our surgeons are up-to-date with the most recent scientific discoveries and pediatric scoliosis treatment options. We can explore ways to enhance your child’s activities and reduce the recovery phase after surgery.

Complications of Untreated Pediatric Scoliosis

A child with scoliosis can suffer from different physical, emotional, and social challenges. Many children do not want to wear their brace to school and among their friends, and therefore, avoid treatment. If your child experiences pain, we urge you to bring your child to us.

When the curve becomes detected early, our doctors can address the symptoms and begin treatment to prevent the curve from progressing. However, if left untreated, the condition can lead to heart- and lung-related problems. Once the spinal curve gets identified, children should undergo regular checkups to monitor any progression.

Health challenges

Although health issues may not occur until the child gets older when changes can occur.  if the curve progresses, it can negatively impact the heart and lung functions. Also, although children may not feel pain at the moment, the abnormal posture can affect activity, cause discomfort and arthritis as they grow.

Appearance

The signs and symptoms of scoliosis affect the shape of the child’s body. If the curve worsens, the physical changes become glaring even when the child puts on cloth. This affects the child’s self-esteem and also tampers with the body image.

Contact Us to Schedule an Appointment

We consider the future growth of each patient as an important component of the treatment plan. Our approach helps children experience the least disruption to their daily routine. As doctors, we understand that children need to be involved in sports, games, and fun things. So, please get in touch with us today to learn more about your child’s scoliosis and to know the treatment options that will improve the child’s quality of life.

Let’s Give Your Child a Bright Future

With today’s technology and medical advancements, treating your child with Pediatric scoliosis can lead to a very successful life for the child. Fortunately, new treatments can help to manage and correct the curve in the spine. Through your support, coupled with the dedication of our scoliosis experts and specialists, we will help your child get on the road to lead a happy life.

The pediatric scoliosis treatment team at the Southwest Scoliosis Institute is available to ensure your child’s continued health. Our doctors stand ready to speak with you about the many ways to treat scoliosis in children. So, call us today at 214-556-0555 to schedule an appointment.

 

 

Growing up, Joy suffered from severe scoliosis which stopped her from many activities she loved.  Joy’s mother brought her to us for an eval.  Dr. Shyam Kishan examined Joy and met with her family to discuss a scoliosis treatment plan,  Dr. Kishan explained everything — every step of the way.  After her successful surgery, Joy resumed all the activities she loves, like archery, horseback riding, and biking to name a few. Call today to schedule an appointment. ~ Joy, Scoliosis Patient

If your child suffers from scoliosis, call Southwest Scoliosis Institute for an examination today at 214-556-0555.