PEDIATRIC SCOLIOSIS HUB

Questions and Answers

Pediatric Scoliosis — Complex and Rare

Children with cerebral palsy have the potential to develop scoliosis during their early years. Pediatric scoliosis is closely related to the severity of cerebral palsy and often continues to progress 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 are 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:

• Congenital Scoliosis: This occurs when the spine fails to develop properly in the womb.
• Infantile Scoliosis: This type affects children between 0 and 3 years.
• Juvenile Scoliosis: This type affects children between 4 and 10 years.
• Early-onset Scoliosis: A form of scoliosis that is detected in children below the age of 10.
• Adolescent Scoliosis: This type affects children between 11 and 18 years. [orthoinfo.aaos.org]
• Neuromuscular Scoliosis: Results from disorders that affect the nerves and muscles supporting the spine. Common conditions include cerebral palsy, muscular dystrophy, spina bifida, spinal muscular atrophy, and polio.
• Syndromic scoliosis: This type of scoliosis is associated with specific genetic syndromes or connective tissue disorders, such as Marfan syndrome, Neurofibromatosis (Type 1), Ehlers-Danlos syndrome, Prader-Willi syndrome, Rett syndrome, or osteogenesis imperfecta.
• Idiopathic scoliosis: relates to a type for which doctors and medical researchers do not know the cause.

When Should Parents Get Concerned – Symptoms of Scoliosis in Children

Signs of scoliosis usually get noticed in the preteen years, and it occurs more in girls than in 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

Early Diagnosis is Critical

Early detection of scoliosis is one of the most important factors in achieving the best possible outcomes. When scoliosis is identified early — whether through school screenings, routine pediatric check-ups, or when parents notice uneven shoulders, hips, or a slight rib hump — the curve is often still mild (less than 20–25 degrees). At this stage, the primary approach is careful observation with regular follow-up visits and X-rays every 4 to 6 months to monitor for progression. If the spinal curve measures more than 10 degrees, it is formally diagnosed as scoliosis, and treatment options may begin depending on the child’s age, remaining growth, and rate of progression.

For many children and adolescents, early detection allows for effective non-surgical management such as custom bracing or specialized physical therapy, which can successfully slow or stop curve progression and often avoid the need for surgery. At Medical City Children’s Orthopedics and Spine Specialists, we emphasize the importance of early screening because catching scoliosis early gives families more treatment choices and the greatest chance for a positive, long-term result.

Pediatric Orthopedic and Scoliosis Center Screening

School health screening often helps to identify scoliosis, and we want to see those patients as soon as possible.  Once seen, our doctors may suggest bracing.  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 their visual exam and see the spinal column clearly to determine the degree of the curve.

The technicians will take the X-rays of 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 images 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.

Only Some Forms of Pediatric Scoliosis Require Treatment

A scoliosis diagnosis can scare parents and children, 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 who 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 who 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 is to stop the curve from growing and correct an 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, a 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 treatments for children and adolescents focus on preventing the curve from worsening. It also involves cosmetic improvement.

Observation

Most children do NOT need 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, scoliosis 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 evidence for treating scoliosis.

Conclusion

Management of scoliosis in children is age-specific and depends on the severity and progression of the curve. Early detection and appropriate intervention are crucial to preventing complications and ensuring optimal outcomes. Regular follow-ups with a pediatric orthopedist are essential to tailor the treatment plan to the individual needs of each child.

How Can Customized Home Exercises Help in Scoliosis Treatment?

Customized home exercises play a crucial role in scoliosis treatment by offering targeted interventions to slow down the condition’s progression. These exercises are tailored to each individual’s specific spinal curvature and unique needs, ensuring maximum efficacy. Here’s how they help:

• Strengthening Core Muscles: Focused exercises improve the strength and stability of the core muscles, which support the spine. Stronger core muscles can better maintain spinal alignment and reduce strain on the spine.
• Enhancing Posture: Tailored exercises encourage proper posture, mitigating the abnormal curvature associated with scoliosis. Good posture can help reduce discomfort and prevent further spinal deformity.
• Increasing Flexibility: Customized routines often include stretches that enhance flexibility, making the spine and surrounding muscles more pliable. Increased flexibility allows for better movement and can alleviate some of the rigidity associated with scoliosis.
• Pain Relief: By reducing muscle tension and improving overall spinal health, these exercises can significantly alleviate pain. Regular practice helps in addressing the muscular imbalances that often cause discomfort in scoliosis patients.
• Slowing Progression: Individualized exercise plans are designed to slow the progressive nature of scoliosis. By maintaining muscle balance and spinal alignment, these exercises help prevent further deterioration of the spinal curvature.

In summary, customized home exercises are integral to scoliosis treatment. They strengthen muscles, improve posture, increase flexibility, relieve pain, and slow the condition’s progression, making them a vital part of managing scoliosis effectively. Our doctors and staff will provide instructions.  Call today for a consultation.

Pediatric Scoliosis Surgery

Scoliosis surgery aims for several crucial outcomes to improve the patient’s quality of life.  Here are the main goals for the surgeons at the Southwest Scoliosis and Spine Institute:

• Halt Further Progression of the Curve: The primary reason for opting for surgery in scoliosis cases is to stop the curvature from advancing. Intervention is intended to permanently stabilize the spine, ensuring that the curve does not continue to increase.
• Rectify the Spinal Deformity: Effective scoliosis surgery attempts to significantly correct the existing spinal curvature. Surgeons work to straighten the spine by approximately 50% to 70%, leading to improved posture and alignment. This not only helps in alleviating physical deformity but also aids in lessening associated symptoms such as the prominent rib hump.
• Preserve Overall Trunk Balance: Adjusting the spine entails meticulously considering the symmetry and balance of the entire trunk. Surgeons strive to retain or recreate the natural curvature of the spine while ensuring that the hips and legs remain as symmetrical as possible. This balanced approach contributes to a more natural posture and minimizes the physical stress on the body post-surgery.

However, it’s essential to understand the broader spectrum of traditional scoliosis treatment approaches, which often extend beyond surgical intervention.

Because non-surgical treatments may not work in some cases, 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 are classified as severe)
• The rate at which the curve grows
• A child’s age, and
• The symptoms and overall health condition of the child

Treatment Options for Mild and Moderate Cases

When children or Adolescents have a mild or moderate case of scoliosis, monitoring and bracing are the primary forms of treatment before surgery is considered. Traditional braces mainly focus on stopping progression and providing short-term pain relief, but they do little in terms of actual correction.

Surgical Procedures

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 is not 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.

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 with less scarring. This is a minimally invasive procedure whereby the surgeons will have access to the spine through different small incisions. The vertebral tethering system is a technique employed in fusionless spinal surgeries to correct curves in the spine.

This method involves the surgical placement of screws along the side of the spinal curve. These screws are then connected by a flexible cord. By tightening this cord, the spine is gradually pulled into a straighter alignment. This approach allows for the correction of the spinal curvature without the need for traditional fusion, promoting a more natural range of motion and quicker recovery.

Spinal fusion surgery, a treatment option for conditions like scoliosis, offers both advantages and drawbacks worth considering. One of its primary benefits is its proven track record in providing long-term safety and successful outcomes. Modern techniques for spinal fusion have also evolved, allowing surgeons to fuse fewer vertebrae and thereby preserve more mobility in the spine compared to methods used in the past.

However, it’s important to recognize the potential downsides. A notable drawback of the surgery is the loss of mobility at the fusion sites. Once vertebrae are fused, those segments of the back can no longer move naturally, which means patients may experience limitations in bending and twisting movements post-surgery.

Risk Management

While spinal surgeons have their patients’ best interests at heart and any surgical procedure comes with its share of risks, spinal fusion is a lengthy and invasive procedure that has a long list of potential side effects and risks of complications. Some patients are disappointed with their level of spinal flexibility, back pain, and cosmetic results post-surgery. In weighing both sides, individuals considering this procedure should discuss their specific circumstances with healthcare professionals to fully understand the potential impacts on their function and quality of life.

Spinal fusion procedure

When addressing scoliosis in adolescents and young adults who are considering surgical options, spinal fusion stands out as the predominant procedure. This surgery is performed more frequently than any other intervention for this age group to correct scoliosis. It involves joining two or more vertebrae to prevent any further curvature of the spine, aiming to restore a more natural alignment. This is widely recognized as the main surgical course of action in managing scoliosis among teenagers and young adults.

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 the Southwest Scoliosis and Spine Institute, we use the least invasive techniques to help your child recover quickly with fewer complications.

Once scoliosis progresses past the surgical threshold (often at 40+ degrees), spinal fusion is recommended to prevent further progression. However, this does not equate to achieving corrective results such as curvature reductions or improved spinal stabilization.

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 grow naturally. The procedure lasts between 4 and 6 hours. If necessary, follow-up surgeries can occur to either remove or replace the rods.

Vertical Expandable Prosthetic Titanium Rib (VEPTR)

Doctors use this system for kids who 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, doctors can adjust the VEPTR system to accommodate the needs of the patient.

MAGEC growing rods

Magnetic Expansion Control rods (MAGEC) are used for kids who 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.

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 braces 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 is 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 is identified, children should undergo regular checkups to monitor any progression.

Health challenges

Although health issues may not occur until the child gets older, 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 and 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 clothes. This affects the child’s self-esteem and also affects their body image.

Recovery Time for Scoliosis Surgery

Most patients undergoing spinal fusion for scoliosis can expect a hospital stay of around three to five days. Within a day of surgery, patients typically begin working with a physical therapist to start standing and moving.

Return to Daily Activities

For children and teens, the path to resuming daily activities is fairly swift:

• School: They can usually return to school within four to six weeks.
• Full Activity: Resumption of full physical activity generally occurs at the three-month mark.

Complete Healing

The overall healing process for scoliosis surgery, including bone fusion and muscle recovery, can take anywhere from six to twelve months. During this period, follow-up appointments and rehabilitation exercises are crucial for ensuring proper healing and the best outcomes.

Combined Procedures

Patients who undergo both anterior and posterior spinal procedures might experience a slightly longer hospital stay compared to those having only posterior fusion. However, modern surgical techniques have significantly reduced recovery times compared to the prolonged hospitalization and use of body casts or traction common in past decades.

Rehabilitation protocols and individualized care plans are critical in guiding patients through their recovery and helping them return to a normal lifestyle as soon as possible.

Post-Surgery Realities

While spinal surgeons aim to provide the best outcomes, spinal fusion is a lengthy and invasive procedure that carries a list of potential side effects and risks. Some patients experience disappointment with reduced spinal flexibility, persistent back pain, and cosmetic results post-surgery.

By understanding the entire spectrum of traditional scoliosis treatment—from early detection and non-surgical options to the realities of spinal fusion surgery—patients can make more informed decisions about their treatment path. This comprehensive approach ensures that the goals of surgery align with the broader objectives of scoliosis management.

These targeted goals of scoliosis surgery are designed to address both the physical deformities and the functional limitations caused by the condition, thereby enhancing the patient’s lifestyle and comfort.

Why Choose Southwest Scoliosis and Spine Institute?

The Southwest Scoliosis and Spine 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 who specialize in orthopedics
• Orthopedic specialists
• Advanced practice nurses and physician assistants who are committed to the best care possible
• Advanced surgical techniques not widely available
• Physical and occupational therapists
• Medical imaging experts
• Specialized scoliosis-focused practice (not general orthopedics
• Extensive experience in complex and revision scoliosis cases
• Positive outcomes for your child’s health supported by Medical City Healthcare Hospital
• We are members of the Scoliosis Research Society

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 who 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, Hostin and Kishan, provide the best and latest scoliosis treatments for children, including a series of minimally invasive scoliosis surgeries.

Personalized care

Doctors Hostin and Kishan 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 questions you have at any point during the treatment and encourage parents to learn as much as possible about their child’s scoliosis.

Experienced and reliable expertise

The Southwest Scoliosis and Spine 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 continue throughout the years to come.

A 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 return to the suspended activities.

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. 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.

Specialized Scoliosis Focus

At Southwest Scoliosis and Spine Institute, we offer a highly specialized scoliosis focus that sets us apart. Our surgeons possess deep pediatric expertise, having dedicated their careers exclusively to treating children and adolescents with spinal deformities. This focused experience allows us to understand the unique growth patterns and developmental needs of young patients.

We also bring extensive complex case experience, successfully managing the most challenging curves associated with congenital, neuromuscular, and syndromic scoliosis — cases that many centers refer elsewhere. Additionally, our physicians maintain strong research leadership, actively participating in clinical studies and pioneering advanced techniques such as vertebral body tethering and growth-friendly surgical systems. This combination of pediatric specialization, complex-case proficiency, and research-driven innovation ensures every child receives the most current, individualized care available.

Families throughout North Texas choose us because they know their child will benefit from a team that lives and breathes pediatric scoliosis every day.

Contact Us to Schedule an Appointment

At our clinic, we understand the individual needs of each patient, especially when it comes to managing conditions like scoliosis. 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. Recognizing that children play sports, games, and fun activities, we tailor our treatments to fit into their lively worlds.

To provide you with the most relevant and specialized information about managing and treating scoliosis, we invite you to share your information with us. This enables us to deliver customized content directly addressing your concerns and questions about scoliosis.

Please, get in touch with us today to learn more about your child’s scoliosis and to discuss treatment options that will improve your child’s quality of life. Reach out for more information tailored specifically to your needs. Your child’s health and happiness are our top priorities, and we are here to support every step of their journey with expert care and comprehensive information.

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 leading a happy life.

The pediatric scoliosis treatment team at the Southwest Scoliosis and Spine Institute is available to ensure your child’s continued health, and we have offices in Dallas, Plano, and Frisco, Texas. 

👉 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.

____________________

Citation: American Academy of Orthopaedic Surgeons – Pediatric Scoliosis

The medical content on this page has been carefully reviewed and approved for accuracy by the Southwest Scoliosis and Spine Institute’s qualified healthcare professionals, including our board-certified physicians and Physician Assistants. Our team ensures that all information reflects the latest evidence-based practices and meets rigorous standards of medical accuracy, with oversight from our expert spine doctors to guarantee reliability for our patients.