By: Brian Kaufman, MD
"I think as a parent we're all always worried about our kids and if you feel something isn't right it's worth getting it checked out.
What Causes Scoliosis?
We think about scoliosis or a curve in your spine as an asymmetric growth of the spine meaning that while you are growing your spine is growing in a crooked fashion or curved as opposed to growing perfectly straight. I think the hardest question for people to answer is why it happens. The short answer is we really don't know.
Most people are diagnosed with idiopathic scoliosis-- idiopathic meaning no known cause. There's a lot of theories behind genes and what causes asymmetric growth in the spine and even though we may not know the exact cause, we are well equipped to treat the condition.
What Are the Symptoms of Scoliosis?
Most people with scoliosis don't have any symptoms other than the visible shape of their spine. It doesn't cause any pain or discomfort and it usually doesn't cause any neurologic symptoms like weakness or numbness or tingling but oftentimes we see physical things. Like your shoulders being higher than the other, a crease in your side that isn't on the other side, feeling like your trunk is shifted to one way or another, and then oftentimes when you bend over it looks like the ribs on one side of your back are higher than the other.
What age Should you be Tested for Scoliosis?
I think it's never too early to screen for scoliosis. The American Academy of Pediatrics recommends that scoliosis screening occurs twice for girls roughly at ages 12 and 14 and once for boys at age 14. Most pediatricians are screening children way more frequently than that and that's totally okay.
A screening is a great way to catch somebody with a curve that's early and like with most progressive conditions, the earlier we find it the better chance we have at preventing that curve from becoming something that needs surgery or more significant treatment down the road. In general, screening kids under the age of 10 probably isn't necessary, however, we do see children under the age of 10 with curves every once in a while.
How is Scoliosis Treated?
Our treatment of scoliosis is based on two main factors: how much growth your child has left and how big that curve is assuming your child is still growing. For curves that are between 10 degrees and 25 degrees, we treat that with observation only. That means we take an x-ray every six months or so to make sure the curve is not progressing.
If we ever see the curves progress past 25 degrees and under 40 degrees, we consider a brace. The goal of a brace is to push on the spine and make the curve straighter while you're wearing the brace. We're trying to guide growth at that point, we're not able to permanently correct the curve but in many cases we're able to prevent it from getting bigger.
Ultimately we want your curve to be under 40 degrees when you're done growing. In that case your curve shouldn't progress any further and will stay that way for the rest of your life. In those cases where the curve is over 50 degrees, that's when we consider surgery to permanently correct the spine and really more importantly, to prevent any further progression of that deformity.
What Percentage of Scoliosis Patients Require Surgery?
The vast majority of patients that we're treating are being treated with observation. A much smaller percentage are getting a brace and an even smaller percentage of that wind up having surgery. Of the people that we're treating with scoliosis, under five percent wind up with surgery so know that the risk of your child needing surgery is incredibly low.
Where to Start?
Our pediatricians in Austin are really fantastic and are well equipped to guide you appropriately. That's what they're there for, they're there to be your resource and your sounding board.
Having a diagnosis of something like scoliosis can be scary both for your child and for you as a parent but know that we're here to support you and guide you in your treatment and ultimately do what's absolutely best for your child above all else."
About Dr. Brian Kaufman
Dr. Kaufman is an assistant professor in the Department of Surgery and Perioperative Care at Dell Children’s Medical Center. He attended undergrad at The George Washington University, followed by medical school and residency at The George Washington University School of Medicine and then fellowship at A.I. Dupont Hospital for Children.
Dr. Kaufman’s subspecialty interests include management of idiopathic, congenital, neuromuscular and post-traumatic spinal deformities. He has lectured nationally and internationally on his research interests in pediatric spinal deformity. Dr. Kaufman is an active member of the Scoliosis Research Society and Pediatric Orthopedic Society of North America, serving on multiple committees in both organizations. Dr. Kaufman and his wife have two children and when he’s not chasing after them, he enjoys hiking, fishing, BBQ, and UT football.
Click here to learn more about Dr. Kaufman.