Pediatric Spine & Scoliosis

Scoliosis in Children

Scoliosis is also known as a curvature of the spine. More specifically scoliosis is defined as a lateral curvature of the spine. Most scoliosis is idiopathic; meaning the cause of the condition is unknown. We do know that scoliosis is not caused by carrying heavy books, or wearing a heavy backpack.

Dr. Jonathan Camp, MD with Children's Bone & Spine Surgery is a specialist in treating and diagnosing children with scoliosis. Schools usually perform routine screenings for scoliosis, and it is often first discovered during one of these simple tests. Which your child is asked to stand straight, with feet firmly together, the examiner will check for alignment of the shoulders and shoulder blades, and look to see if your child’s hips are level and his or her spine is straight. Next the child will be asked to bend forward at the hips. Children with scoliosis, will appear to have an elevation of one side of the back, or a “rib hump” upon bending forward. If your child is referred to a specialist due to one of these screenings, do not panic. First of all few children who test positive in a screening have scoliosis. And even if they do, the condition rarely requires any treatment other than observation or simple bracing.

Diagnosis
To confirm the results of a screening exam, an x-ray will be taken to detect the exact degree of curvature of the spine. Depending on the degree of curvature your doctor will discuss treatment options with you.

Treatments for Scoliosis
Scoliosis is rarely crippling or life threatening but if left untreated it can lead to breathing and heart problems later in life. There are both non-surgical and surgical treatment options for children with scoliosis, depending on the severity.

Non-Surgical

• Observation. In children with a mild curve, less than 20°, no treatment is really required other than to watch and make sure the condition does not worsen. You will likely be asked to return every 3 to 6 months for re-examination and x-ray. Most instances of scoliosis in children discovered during a school screening will be of this degree
• Bracing. The goal of bracing is to prevent the curvature from getting any worse. Bracing is most effective before the child has reached skeletal maturity, and if the curvature is no greater than 40°. There are several types of braces. Most bracing starts using night time only treatments. Your pediatric orthopedist will recommend a brace that is best for your child and discuss how it should be worn. If your child participates in sports, “time-outs” from bracing are allowed to participate in such activities.

Surgical Treatment

The techniques in use today involve correcting the curvature with dual metal rods attached to the spine with either screws, hooks or wires. Once corrected the surgeon will “fuse” the spine by removing the joints an the outer boney layer followed by a bone graft. The bone graft traditionally has been taken from the posterior iliac crest (pelvis). Dr. Camp uses local bone graft taken from the area of the spine during the surgery iself and does not routinely ake an iliac crest bone graft. This bone graft harvesting technique decreases blood loss, saves surgical time (which decreases blood loss) and decreases post operative pain. Often the bone graft harvesting site on the pelvis is more painful than the surgery on the spine. Patients are in the hospital for 4-7 days, often don’t require a blood transfusion and leave the hospital on pain pills and multivitamins with no cast or brace for support of their spinal fusion. Activity is restricted for only about 3 months.

Check out: http://www.settingscoliosisstraight.org/
 

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