Scoliosis is a spinal condition that often develops during
childhood or adolescence. For that reason, it is recommended that children
be screened or checked for abnormal spinal curves at their yearly checkups
or through school screening programs. But what exactly are doctors looking
for when they check a child's spine and why is it important to check
regularly? Read on to find out more about scoliosis and why screening and
early detection are so important.
What is scoliosis?
To understand
what scoliosis is, we need to know what a healthy spine looks like. When
viewed from the front or back, the spine should look straight from the
neck to the buttocks. When viewed from the side, a healthy spine should
have a small outward curve in the upper back and a slight inward curve in
the lower back. These natural curves position the head over the pelvis and
help the spine work as a shock absorber to distribute mechanical stress
during movement.
The spine of a person with scoliosis
however, curves to the left or right making the spine look S- or C-shaped.
The curves of scoliosis are most easily seen when the patient bends
forward. Abnormal curves can interfere with the spine's ability to
function properly and if left untreated, can become worse.
What causes scoliosis?
While
scoliosis can have many causes including birth defects, neuromuscular
disorders, connective tissue abnormalities, or injuries to the spine, the
most common cause is termed "idiopathic," which means the exact cause is
unknown. Idiopathic scoliosis most commonly affects young people ages
10-16 and is termed Adolescent Idiopathic Scoliosis, or AIS. And while
good posture and avoiding carrying heavy loads (such as backpacks) is
important for good spinal health, they do not impact the development of
scoliosis.
Why screen for scoliosis?
Because
scoliosis often begins in childhood during times of rapid growth, it is
recommended that children be screened for scoliosis by their primary care
physicians at their yearly checkups. In some communities, school nurses
are able to conduct comprehensive scoliosis screening programs in the
schools. If scoliosis is suspected, a simple x-ray of the spine can
confirm if an abnormal curve is present. Early detection is key to
stopping or slowing the progression of abnormal spinal curves.
How is scoliosis treated?
Spinal
curves are measured in degrees. Curves that measure 25º or less in a
patient that is still growing are not considered severe. For these
patients, regular monitoring of the spine (every 4-6 months) by a spine
specialist is all that is needed to ensure the curves are not progressing.
Curves that progress rapidly or are over 30º usually require treatment in
the skeleteally immature child.
The most common treatment for
scoliosis is observation in which the patient is watched for any increase
in the curvature. Bracing may be indicated if progression of the scoliosis
is noted. Wearing a back brace for a length of time during periods of
growth (such as during puberty) can help slow or stop the curves from
progressing. This is important because if left untreated, scoliosis can
cause a variety of problems such as:
• A difference in shoulder height
• Muscular prominence on one side of the back
• Breathing
problems
• Heart problems
Severe curves or curves that progress
even after the use of a back brace may require surgery. The most common
surgical procedure to treat scoliosis is a spinal fusion. In this surgical
procedure two or more vertebrae are fused together in order to correct
abnormal curves and to stabilize and strengthen the spine. In many fusion
surgeries, special implants such as screws, rods, wires, or cages are used
along with bone growth materials to help facilitate successful fusion. In
addition, thanks to recent advances in surgical technology, some patients
can have this procedure done using minimally invasive techniques. These
techniques are quicker, require smaller incisions, and may have faster
recovery times for the patient.
What you can do?
Because
idiopathic scoliosis has no know cause, it is impossible to completely
prevent it from occurring. However, regular checkups during childhood are
an important way to monitor a child's spinal health and allow for early
detection and treatment if problems arise. Of course, regular exercise,
eating a balanced diet, and not smoking are also great ways to keep the
spine and the entire body healthy and strong.
If you are concerned about your
child's spine, talk to your physician. Having your child screened for
scoliosis is quick and painless and can prevent future health problems
from happening.
