Scoliosis is an abnormal spine curvature in the shape of a C or S. If the spine grows sideways, it can affect a person’s posture for life. The condition is often mild, but spinal deformity may worsen over time. Severe scoliosis can be painful and disabling.
Scoliosis most often develops as children undergo a growth spurt before puberty, but can occasionally appear in adults. The condition is more common in girls than boys. Most children receive regular scoliosis screenings at school and by their pediatrician. If your pediatrician has recommended you see an orthopaedist who specializes in scoliosis, contact MedStar Montgomery to find a fellowship-trained orthopaedic surgeon.
- Uneven hips, shoulders, or waist
- Protruding shoulder blades
- Uneven waist
- Leaning to one side
- Difficulty standing straight
- Bulge or bump on the back
Scoliosis can have a number of different causes:
- Idiopathic scoliosis has no identifiable cause. Most cases of scoliosis are idiopathic and this is the most common type of abnormal spine curvature seen in adolescence. There is some evidence that this form of scoliosis may be inherited. Idiopathic scoliosis can worsen during a child’s growth spurt, but tends to remain stable during adulthood.
- Congential scoliosis is caused by a bone abnormality that is present at birth
- Neuromuscular scoliosis is caused by abnormal muscles or nerves that do not function properly. This form of scoliosis is most often seen in people with spina bifida, cerebral palsy, or conditions that involve paralysis.
- Degenerative scoliosis may be caused by trauma due to injury or illness, the collapse of vertebrae, previous back surgery, or osteoporosis.
Can the curvature be corrected?
Although scoliosis cannot be fully cured, it can be managed to prevent pain and disability.The team of expert orthopedic specialists at MedStar Montgomery carefully assess any patient with suspected scoliosis. A initial visit for scoliosis generally includes:
- Taking your medical history; including asking questions about medical problems that might affect the spine, such as birth defects and injuries
- Physical exam of the child’s back, shoulders, waist, arms, and legs carefully, looking to see if both sides of the child’s body are even with each other
- X-rays – The orthopedist will likely order an X-ray of the spine to see and measure the extent of the abnormal spinal curvature, and whether any of the vertebrae are out of place.
Our specialists spend time educating families about their spinal condition and treatment options. Our doctors will make recommendations for your child based on the extent of abnormal spine curvature, whether they are experiencing pain, and their age. Whenever possible, they encourage regular observation to ensure mild scoliosis does not progress. In some cases, bracing and physical therapy may be recommending.
Wearing a brace to halt curvature progression is a typical non-surgical treatment for scoliosis. Braces do not usually straighten the spine, but they are recommended for patients with a significant abnormal spinal curve to keep the curvature from worsening as the child grows.
Surgery is generally only recommended when the spinal curve reaches 40 degrees and other non-surgical treatments do not relieve the pain and other symptoms of spinal deformity. If surgery is recommended, our expert team of orthopaedic surgeons will work with you and your family to determine the most effective and advanced surgical option. During scoliosis surgery, orthopedic surgeons use a bone graft to unite vertebrae and reduce spinal curvature. Surgeons also place metal implants to straighten and stabilize the spine until the bone graft strengthens. While scoliosis surgery cannot make the spine completely straight, it can help correct severe curvature, reducing pain and disability.
SCOLISCORE™ AIS Prognostic Test
MedStar Montgomery offers the SCOLISCORE™ AIS Prognostic test. Approved by the U.S. Food and Drug Administration after a series of clinical trials, this test is a way to determine who is at risk for curve progression. Using a simple saliva test, the lab can determine, using a DNA footprint, whether your child's curve needs treatment. Before SCOLISCORE, the majority of children and teenagers at risk for scoliosis needed an X-ray every six months to determine the growth and development of their curvature. Most children’s curvature will not progress, but it was impossible to know which children were at risk before SCOLISCORE. SCOLISCORE can identify the 60-70 percent of children whose scoliosis will not progress, eliminating the need for X-rays every six months.