Children with Scoliosis
After running various exams and
tests, your doctor will develop a treatment plan for your child's
scoliosis. Often with a small curve, the first step is observation—giving
the curve some time to see if it progresses. Your child will be examined
every 3 to 4 months, and during that examination, the doctor will order an
x-ray if it seems that the curve has increased. It's important to minimize
the number of x-rays that are taken (because of the radiation exposure),
and in most cases, one x-ray per year should be
sufficient.
However, with more severe curves or
with curves that are likely to progress, bracing is a terrific
non-surgical treatment option to try to stop the curve from getting worse.
Before recommending bracing, the
doctor will determine:
- how much growing your child has
left to do.
- where the curve is—because a curve
in the mid-back (thoracic spine) is much more likely to get worse than a
curve in the low back (lumbar spine).
- how severe the curve is and how
the curve is affecting your child's life.
- how likely it is that the curve
will get worse—because if the curve is already rather severe and your
child hasn't gone through his or her adolescent growth spurt, it will
most likely get much worse when he or she does grow.
Bracing is the usual treatment for
children with curves greater than 20° and at least two years of growth
remaining. Bracing is usually not prescribed when the curve is greater
than 40°. In that case, surgery may be necessary.
It's important to remember that a
brace can help stop the curve from progressing, but it generally
won't fix the curve that's already there.
Wearing a brace is a big commitment,
one that parents and children need to work together on. Here are some key
points to remember if you want bracing to be as effective as
possible:
- Just what the doctor ordered: Your
doctor will decide what type of brace is best for your child's curve and
how long he or she should wear it every day. Some children must wear
their brace up to 23 hours a day, and while that's an intimidating
number, it's absolutely crucial that your child wear the brace for the
full time. Your doctor will work with you to figure out when your child
doesn't have to wear his or her brace. If he or she likes swimming, for
example, the doctor will probably arrange the brace schedule so that he
or she is out of the brace during your swim team practices.
- Wear it well: Your child may be in
and out of your brace a few times during the day—during gym class, for
example. It's important that every time he or she puts the brace back
on, it's tight enough and properly positioned. If it isn't, it won't do
as much good.
- Watch what you wear: Underneath
the brace, your child should wear a shirt that fits well and doesn't
wrinkle. This will help protect his or her skin because otherwise, it
can get irritated from the brace. Over the brace, your child can wear
normal clothes, although you might have to get clothes a size or two
bigger in order to fit over the brace.
Bracing can be
uncomfortable—both physically and emotionally. At a time when kids don't
really want to be different, a brace is a very noticeable difference. But
with support from family, friends, and medical professionals, kids get
through it just fine…and usually with a healthier back at the end of
it!
