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A closer look at pediatric scoliosis

Last Modified: July 11, 2021

Women & Children, Family Medicine

pediatric scoliosis

You’ve likely heard of scoliosis, but did you know that the condition is often found in adolescents between 10-12 years old? This is why it’s imperative that parents and caregivers ensure their child receive regular checkups, so the condition can be diagnosed and managed early. Fortunately, Deborah Abaitey, MD, PPG – Pediatrics, helps shine a light on the subject by explaining what scoliosis is, the most common types and what symptoms parents should watch for as their child grows.

What is scoliosis?

Scoliosis is a three-dimensional spinal deformity that consists of curvature and rotation of the spine.

What are the most common types of scoliosis?

There are several types of scoliosis. Let’s take a closer look and delve into each one:

  • Idiopathic: This is the largest category of scoliosis. The name idiopathic is often used in cases where there is no definite cause. From there, idiopathic scoliosis gets broken down by age:
    • Infantile: Occurring and seen in children from birth to three years
    • Juvenile: Typically observed in children from 4-10 years old
    • Adolescent: Usually seen in children from 11-18 years old, affecting females more frequently than males
  • Congenital: In this category, patients are born with a spinal deformity, in which there are bone malformations that can cause scoliosis to develop.
  • Neuromuscular: This type of scoliosis occurs when nerve abnormalities affect the nervous system and muscles in the spine like cerebral palsy, spina bifida and muscular dystrophy.
  • Myopathies: Diseases of muscle degeneration and weakness like Duchenne muscular dystrophy can also cause scoliosis.
What are the signs and symptoms of pediatric and adolescent scoliosis?

While the signs of scoliosis can vary, the more common symptoms associated with the condition can include:

  • A rotating spine
  • Uneven hips and shoulders
  • Constant leaning to one side
  • Prominent shoulder blade(s)
  • Some people complain of back pain, but it’s not typical

If you see any of these in your child, be sure to speak with your primary care provider or your child’s pediatrician to have them screened.

How is the condition diagnosed?

In most cases, a physical exam of the spine is the first step a doctor will take to see if someone has scoliosis. They may also order some imaging tests to get a closer look at the spine. This is what someone can expect:

  • Physical exam: A provider may evaluate someone with scoliosis by performing a physical exam and/or Adam’s forward bend test. Either test will allow your provider to observe your back. They will check for spine curvature in your upper and lower back while also looking to see if your shoulders and waist are symmetrical.
  • Imaging: A scoliosis diagnosis may also get confirmed by way of a scoliosis x-ray, a safe and painless test that can obtain detailed images of the spine. It helps calculate the extent of the curvature of the spine.
What are the treatment options for the condition?

The treatment for pediatric scoliosis depends on several factors, including:

  • The child’s age
  • A family history
  • The type of scoliosis
  • The degree of the curve
  • The number of growth years until skeletal maturity

Usually, children with mild cases may only need observation or monitoring every 4-6 months. Those individuals with more severe cases may require a custom brace to prevent any progression of the condition. If the prescribed brace is unable to control the spinal curve, surgery may be necessary. Providers only recommend when the spinal curve is greater than 45 degrees.

How early should children be screened for scoliosis?

Ideally, screening should start from birth because some bone deformities can cause scoliosis. But screenings should also take place as children get older. Because scoliosis is not always apparent until the spine is severely curved, many providers recommend that children be screened annually for scoliosis. It’s best to screen girls between the ages of 10 and 12 and boys between the ages of 13 and 14.

What can parents and caregivers do to help a child diagnosed with scoliosis?

Parents and caregivers should encourage their child to be compliant with any treatment option used for the management of their scoliosis (wearing a brace, going to physical therapy, etc.). Additionally, they should also provide a great deal of emotional support. Depending on the severity of their condition, especially during adolescence, their self-esteem may be affected.

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