Childhood Scoliosis - Frisco, TX
Childhood Scoliosis refers to a physical deformity of the spine marked by a sideways tilt or curve that occurs in the spine of the children or adolescents. It is also referred to as an idiopathic scoliosis as its cause is difficult to establish. This deformity changes the shape of the spine from a straight line to a ‘C’ or ‘S’ shape by twisting and rotating the vertebrae. The deformity can become noticeable at the age of 10 years and may progress for a few years until the child attains puberty after which the bones stop growing.

Childhood Scoliosis is observed to affect the thoracic spine more than the lumbar or the cervical. Most children develop mild curves and these may go unnoticed as the condition does not create many symptoms. However, in case of severe alteration of the spine, the child needs to be given immediate medical treatment to prevent the disease from progressing. Girls have been observed to develop larger curves as compared to boys especially during puberty.

Causes

  • Congenital disorder- the spine of the baby may not develop fully or the bones may not have fused in the right direction resulting in the birth of a deformed baby
  • Neuromuscular disorders such as cerebral palsy or muscular dystrophy may be a potential cause of Childhood Scoliosis as the supporting muscles of the spine become dysfunctional
  • Genetic history of the family can predispose a child to this problem
  • Arnold-Chiari Malformation- an inherent disorder in which the brain stem may not be fully developed and it lies lower than its normal position
  • A cyst in the spinal cord (Syringomyelia) may be the cause

Symptoms

  • Presence of tilted shoulders
  • The child may develop a protruding shoulder blade
  • The ribs may be seen jutting out prominently on one side of the body
  • The waistline and the hips may be tilted with one side appearing to be higher than the other
  • In severe cases of deformity the child may not be able to breathe properly as the lung capacity is restricted
  • Altered gait

Diagnosis

  • The problem can be diagnoses through the following procedure
  • A detailed assessment of the family and medical history of the patient
  • Adam’s Forward Test- a physical test in which the patient is asked to bend the body forwards by keeping the feet together and allowing the arms to hang freely on either side
  • The alignment of the shoulders, hips, waist, chest and legs is observed
  • Limb length is measured to check for discrepancy
  • Neurological tests may be required to assess loss of nerve conduction or sensation
  • X-ray imaging gives a clear picture of the vertebrae and the degree of curve that has set in
  • The abdominal muscles which support the spine are also checked to evaluate if they are causing any stiffness or undue pressure on the cord

Treatment

  • The treatment for Childhood Scoliosis can be both surgical and non-surgical and depends on the severity of the curve, its location as well as the patient’s age. It may include the following methods.
  • A curve of less than 25 degrees is put under regular monitoring to ascertain if it is progressing. No immediate treatment is required unless it gets worse
  • Bracing- A spinal curve between 25-45 degrees is corrected through bracing. This method of treatment is used to prevent the deformity from aggravating and a customized under-arm brace is created for the child to wear all day. It needs to be replaced every 12-14 months as the child grows and the brace size needs alteration
  • Surgery- in case the curve progresses to a curve greater than 45 degrees which cannot be prevented even by bracing, surgical realignment of the vertebrae is done. The spine is straightened and then the bones are allowed to grow naturally resulting in their fusion into a single bone mass.
  • Bone graft- Pieces of bones may be extracted from other parts of the body and placed in between the inter-vertebral spaces. The bones then fuse together naturally and this prevents the scoliosis from progressing. Metal rods and screws may be inserted to hold the pieces of bone together and give stability to the spine