Scoliosis

Diagnosis

In order to diagnose the doctor will need to have the full medical history of the child and perform a physical exam. The doctor will check the shape and motion of spine and may also perform a neurological exam to check for muscle strength, sensation and reflex.

Imaging tests

Primarily, X-rays will be done in order to confirm the scoliosis as it is a modality that could see the severity of the spinal curvature. In order to minimize the exposure to radiation, the doctor may suggest to do ultrasound or to use an imaging system creating a 3D model of the spine. As well as the above, the doctor may suggest magnetic resonance imaging (MRI) if the doctor suspects that there are any other problems such as spinal cord abnormality which could not be seen by the modalities above.

Treatment 

When it comes to the topic of treating scoliosis, many of us tend to perceive surgery as the only option available. However, that is not always the case. Upon consultation with a doctor regarding the disease, the specialist will advise the patient for a spinal X-ray to diagnose and assess the severity of the spinal curvature. Also do a physical examination to identify the degrees of the deviation of spine and a neurological examination to determine the function of nervous system. Then a suitable treatment option will be considered by an experienced specialist for each patient.

Although surgery is highly effective in treating the condition, scoliosis can often heal itself over time. Generally, your doctor will monitor the condition from the time it first becomes apparent. They will measure the curvature of the spine to establish a benchmark and use this measurement to determine if the condition improves or worsens.

If the condition is caught early, a back brace may be prescribed as a preventive treatment to keep the scoliosis from worsening. However, the back brace will not cure the curvature that has already occurred.

Braces

For patients who are in mild or moderate stage of scoliosis or the curve is at around 25-45 degrees, they are recommended to wear a close-fitting brace, which is specifically designed for certain individuals to control the curve from worsening. For the brace to work effectively in preventing the progression of the curve, it should be worn continuously for about 20 hours a day. After the bracing treatment has started, follow-up appointments will be made to assess the curvature of the spine and regularly adjust the angle of the brace. Usually, the scoliosis brace should be worn until the spinal cord stops growing. To make sure the spinal curve will not deviate further.

Surgery

Severe scoliosis typically progresses with time, so your doctor might suggest scoliosis surgery to help straighten the curve and prevent it from getting worse.

• Vertebral Body Tethering. Currently, there is a new surgical spine procedure called Anterior Vertebral Body Tethering Procedure (AVBT). It’s performed by using a fusion-less system along with growth modulation techniques to treat scoliosis in children. With this procedure, the spine is able to grow along a healthier path. The surgeon will use the strong and flexible cable/polymer (polyethylene-terephthalate) to adjust the curves of the spine. Moreover, the patient will receive very little trauma on the tissue of the back which leads to faster recovery time. Most patients are able to play sports within 6 – 8 weeks after the surgery.
• Expanding rod. In a still-growing child who exhibits severe scoliosis, growing systems surgery is used to anchor rods to the spinal column. Every six to twelve months, the rods are lengthened in another procedure to keep up with the child’s growth. The procedure keeps the curvature from becoming worse and adversely affecting the overall health of the child.
• Spinal fusion. The fusion procedure is used when the patient has stopped growing. Patients who have undergone the growing systems surgery typically have a fusion procedure performed once they reach their late teens. In this surgery, two or more vertebrae next to each other are fused, and over time they form a solid bone. The downside of this treatment is it reduces back mobility in patients to some degree. However, recent improvements to the procedure have enabled surgeons to reduce the number of fusions along the spine thereby increasing the mobility of the patient.