Scoliosis: Treatment in Children

Scoliosis is defined as a lateral curvature of the spine and is typically more prevalent in girls than boys. Children between the ages of 10 and 16 may develop “C” or “S” shaped curves that may continue to bend the spine and create deformities as the child grows. Typical screening for scoliosis is performed by the pediatrician, annual school exams, hospitals and community awareness programs. If the curvature of the spine exceeds 20-25 degrees, treatment is indicated.

Treatment for Mild Scoliosis
Often, parents first notice mild scoliosis in their child by the appearance of one shoulder or hip slightly higher than the other. The treatment in a mild case is observation of the spinal curve which is measured by the pediatrician overtime. The spine is monitored with periodic x-rays and visual techniques every four to six months to ensure the angle of the curve does not worsen in the course of the child’s growth.

Medical Braces for Moderate Scoliosis
If the curvature has progressed or exceeds the mild form of scoliosis, the pediatrician may elect to prescribe a brace to prevent further deformity. The brace holds the patient’s backbone in an erect position and supports the spine during growth spurts. Several models of braces are available and can be custom made to accommodate all types of curvatures at different locations of the spine. Most of these spinal braces are constructed with form-fitting plastics that are molded to the patient’s individual requirements. Typically, the pediatrician dictates how many hours per day the brace must be worn for the duration of the child’s growth period.

Types of Braces for Scoliosis

• Milwaukee Brace: Used to correct any curvature in the spine. The brace extends from the base of the skull to the pelvis. This type includes a neck ring. The brace is intended to minimize further progression of a curve between 25-40 degrees.
• Thoraco-Lumbo-Sacral-Orthosis (TLSO) Brace: The treatment of choice for mid to lower back spine curvatures, the brace fits under the arms and extends around the chest and down to the hips. The advantage of a TLSO brace is that it can be worn under the clothes.
• Providence Brace: A brace designed for bedtime use and can be worn by the child comfortably for up to eight hours while sleeping.

Complications of Severe Curvatures
As the angle of the spinal curve becomes more severe, the ribcage can twist and restrict normal breathing. In progressive “S” curves, the pelvis may rotate and cause significant leg length discrepancies and result in one leg shorter than the other. Surgery may be indicated for severe scoliosis.

Surgical Interventions for Severe Scoliosis
If moderate scoliosis does not respond to bracing, the condition is often treated with back surgery by an orthopedic surgeon. The procedure fuses the vertebrae of the spine with a rod, or uses the insertion of an implant, and straightens the spine to prevent further progression of the spinal curve. Typically, post surgery requires several days in the hospital and activity of the child is limited for approximately one year.

Overview of Scoliosis
Scoliosis in children must be monitored and treated throughout their growth and development. Treatment is based on the child’s age, degree of curvature and the risk of progression. Mild curves frequently don’t progress into moderate or severe curvatures, but bracing or surgery may be indicated at some point due to the child’s growth spurts. Any form of scoliosis requires monitoring and medical care by a qualified physician.

About MMAR Medical: MMAR Medical Group Inc. is one of North America's premiere medical orthopedic brace distributors, carrying a large selection of TLSO braces for scoliosis. Based in Houston Texas, www.MMARMedical.com also carries one of the largest selection of orthopedic back braces in the Americas.