Scoliosis: What Parents Need to Know

TulsaKids has teamed up with The Children’s Hospital at Saint Francis to bring parents important health information that they need to know.

Mark Schwartz is a pediatric orthopedic surgeon with Warren Clinic. He spoke with us about scoliosis, how and when it is typically diagnosed, what signs parents can look for and what treatment options are available. Watch the video interview below, or read the article to learn more.

Scoliosis definition and diagnosis

Dr. Schwartz says that scoliosis is “any abnormal curvature of the spine.” It is most commonly diagnosed in early adolescence, but early-onset scoliosis can be seen in young children. Pediatricians or family healthcare providers screen for scoliosis. In addition, some schools still do scoliosis screenings. If there is a positive finding from the physical exam, then an X-ray will provide a further diagnosis.

Most scoliosis forms as children grow rather than the rarer “idiopathic” type that is congenital. Scoliosis often becomes worse as children develop and go through growth spurts. Researchers currently don’t know what causes scoliosis.

Early diagnosis is important in order to stop the curvature before it gets worse.

Treatment options for scoliosis

“Our standard treatment option for mild curvatures is just observation,” Dr. Schwartz says. “We tend to see these kids back every six months to get new X-rays to make sure the curve is not getting bigger.”

For those with a moderate curvature, bracing is used to keep the curve from worsening. While it doesn’t make the curve go away, the idea is to hold the curve so that it doesn’t worsen during growth spurts.

If bracing is ineffective, or if the curve is severe, surgery is the treatment option.

“We know that bigger curves tend to continue to grow and progress throughout life,” Dr. Schwarz says. “Curves that stay below 50 degrees tend not to continue to grow throughout life, so typically won’t need any further treatment once the child is done growing.”

The goal of observation and bracing is to keep the curve from becoming severe, which can cause lifelong problems unless it is corrected with surgery.

Problems related to scoliosis

An adolescent or child with mild curvature (less than 50 degrees) won’t have significant problems. Dr. Schwartz says their incidence of back pain is no more than children who don’t have scoliosis. They can participate in any activities and sports.

“Kids with more severe scoliosis also tend not to have any significant problems, as long as we’re catching those curves early on before they’re really severe,” Dr. Schwartz says. “That’s why we try to take care of those early. Later on, as those curves continue to progress, if nothing is done about them, that can start to cause further problems. It can cause problems with heart function, lung function and also causes deformity and potentially pain with those larger curves.”

Early detection can keep children from needing surgery.

Signs to look for

Many parents will notice scoliosis in the summer when children are in bathing suits. They will see that their child’s back is not straight.

Other signs to look for include asymmetry of the shoulders, waistline and sometimes the shoulder blades. A “rib hump” that sticks out on one side over the other is another symptom.

“Scoliosis isn’t just a curvature of the spine,” Dr. Schwartz explains. “It also has some rotational deformity with it as well. It can look like they have bigger muscles on one side as opposed to the other, but that’s really just the rotation of the rib cage that’s attached to the spine.”

Can scoliosis be prevented?

“There’s nothing specific at this point that we can do to prevent scoliosis,” Dr. Schwartz says. “We have our treatments with bracing to be able to prevent scoliosis from getting worse and becoming a bigger curve that would necessitate surgery, but, unfortunately, we don’t have any treatments yet to be able to prevent scoliosis altogether.”

Do lifestyle habits contribute to scoliosis?

While bending over computers, phones, laptops and tablets for long periods may create problems, they do not lead to scoliosis.

“We definitely see problems from [leaning over screens], but scoliosis is something that likely is happening from genetics or something else,” Dr. Schwartz says. “It’s not happening from anything that they’re specifically doing. A heavy backpack is not going to cause kids to develop scoliosis.”

However, Dr. Schwartz says that doctors are seeing more children and adolescents coming in with neck and back pain, which can be caused by poor posture and too much time sitting over computers and video games. Sitting with poor posture and not getting enough exercise can lead to back pain and other issues later on.

Tips for parents for overall spine health

“It’s very important that parents are taking their kids for their yearly checkups,” Dr. Schwartz says. “It’s something that they can bring up with their pediatrician if they’re noticing the pediatrician doesn’t seem to be checking for scoliosis. I think the majority of pediatricians and family docs are doing a great job with it. They’re finding these kids early, and they’re getting them in to us early to be seen.”

Early diagnosis and treatment of scoliosis typically creates better outcomes for the patient.

In terms of general spine health, Dr. Schwartz recommends that kids get outside and do physical activities rather than sitting and playing video games.

“Being overweight can definitely affect overall spine health,” Dr. Schwartz says. “So trying to keep kids active is very important for spine health.”

Poor posture or unusual sitting positions when kids are using screens can affect spine health as well. Dr. Schwartz suggests that parents keep their children off screens for at least part of the day; making them more aware of posture and keeping them active can help keep their backs “nice and strong.”