Scoliosis in Children

This is an unfortunate condition that afflicts children and adolescents. It changes the curvature of the spine to go sideways instead of remaining a straight line. The most common cause of scoliosis is idiopathic (about 80%)…which basically means that the exact cause is unknown. There are three main types – including infantile scoliosis which occurs between the ages of 0-3 years, being more common in boys and disappearing with time, the juvenile scoliosis which occurs between the ages of 3-10 years and the adolescent scoliosis which occurs between the ages of 10-18 and more prevalent in girls.

Other types of scoliosis include congenital scoliosis where something goes grossly wrong during development in the womb resulting in malformed vertebra, and neuromuscular scoliosis due to underlying medical conditions including cerebral palsy, spina bifida, spinal tumors or muscular dystrophy, conditions where the children are unable to walk.

The spine consists of numerous small bones called the vertebrae which are held together by an elastic tissue called cartilage; this provides the spine with the flexibility to bend, stretch, walk, balance, etc. In scoliosis, the vertebra forms a curve like a ‘C’ or an ‘S’ instead of being straight, and might even result in a rotated spine. It can affect both the thoracic and the lumbar vertebra.  The child with scoliosis will appear to be leaning towards one side permanently.

A curve greater than 10 degrees is considered as scoliosis, which shouldn’t be mixed-up with poor posture. In some cases, the curves are only small and do not require intervention, but others may require bracing or even surgery in some extreme cases.

Symptoms: The most commonly seen symptoms include a difference in the shoulders and shoulder blade heights and positions, a possible hip rotation, the head may not be central to the body or the arms may hang differently on the sides of the body. There may also be a deviation from the normal in bladder and bowel habits.

But if the most prevalent symptom in your child is back pain or leg pain, then he/she needs urgent attention.

Diagnosis: Aside from the medical history, x-rays are the main diagnostic tools in confirming scoliosis and allow the doctor to determine the exact curvature of the spine. Other diagnostic tools used include MRI or CT scanning to determine the involvement of other areas. Successful treatment is based on early detection.

Treatment: Specific treatment is based on the child’s age and medical history, the cause and extent of scoliosis, the child’s tolerance to specific medications, procedures or therapies.

Small curves of less than 25% don’t present with immediate issues and only need repeated examinations for changes as the child’s skeleton grows. Increase in curving slows down or stops after puberty. When the curve is greater than 45%, surgery is usually recommended. Bracing, though uncomfortable, is used when the curve is in-between 25-30 degrees.

As it can cause heart and lung issues, regular follow-up is essential as the child’s skeleton grows.

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