What are the signs and symptoms of scoliosis, and what treatments are available?
Scoliosis is a rotational growth of the spine that most commonly occurs in children, especially during the adolescent growth spurt. Common signs are an altered back and trunk shape, which can be seen well when a child is bending forward at the waist as if he or she is going to touch his or her toes.
In this position, one side of the rib cage or back muscles will stick up more than the other. Sometimes, this causes one shoulder to appear higher than the other when standing, or leads to an exaggeration of the space between the bottom of the ribs and top of the pelvis on one side.
Scoliosis may be associated with pain, although usually only with larger curves of the spine. Not every child has pain with scoliosis.
Treatment depends on how big the curvature is on X-rays and how much more the child will grow. If the curve is small enough and the child is not expected to grow much more, then observation and counseling on good back health may be all that is necessary. If the curve is moderate in size and there is growth remaining, then an underarm brace may help to limit further increase in curve magnitude until the patient is done growing. Braces for scoliosis do not correct the scoliosis, which is why pediatricians typically screen for back shape changes as part of an annual physical exam.
If the curve is large enough that it may continue to progress into adulthood and lead to an increased chance of back pain or possible lung restriction, surgery is discussed.
The classic surgical treatment of scoliosis is a spinal fusion to improve current alignment and limit further curving of the spine with more growth. A fusion operation does limit growth and motion across any spinal level included in the fusion. Newer techniques that are under investigation at UVa Health include possible changes to the growth of the spine or a less rigid option for spinal correction.
If you have a child with possible scoliosis, specialists at UVa Children’s at the Battle Building have specialized training in taking care of children with scoliosis from infancy to college. For more information, or to make an appointment, call (434) 924-2301.
Dr. Keith Bachmann is a pediatric orthopedic specialist in the Department of Orthopaedic Surgery at the UVa Health System.