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Pediatric orthopedic specialists at American Family Children’s Hospital in Madison, Wisconsin evaluate and treat scoliosis, a disorder of the spine that results in twisting and bending of a normally straight spine.
What is scoliosis?
Scoliosis is, in essence, a curved spine. For some people, the curve gets worse as they grow, and a brace is necessary. For a few people, spinal surgery is needed to correct scoliosis. Scoliosis affects about one in 1,000 children.
Severity of Curve
X-rays help our physicians determine the degree and severity of curves in the spine and the progression of the curve. Most curves measure from 10 to 50 degrees.
Generally, people who have mild to moderate curves live normal lives. Their sole concern in regard to the deformity is to ensure that their children are closely watched for the development of scoliosis.
More severe curves can cause more problems. Severe idiopathic scoliosis can affect life in three ways. Severe scoliosis can result in an unusual physical appearance of the back, shoulders and hips and may occasionally cause back pain. Finally, scoliosis can be life-threatening in extremely rare instances when the curve progresses to greater than 100 degrees. In these highly unusual instances, the spinal deformity can cause serious problems with heart and lung function.
Once scoliosis has been detected, treatment is based on an individual’s curve magnitude and remaining growth potential.
- Observation: Children who are still growing and have curves that are less than 25 degrees are carefully followed with X-rays that are taken every five months. Further treatment such as bracing or surgery is only required if the curve continues to progress. If a child has finished growing, X-rays only need to be taken every other year until no further progression is documented.
- Bracing: For people who are still growing, curves from 25 to 40 degrees may be treated with bracing. Bracing is designed to hold the curve and to prevent further progression during the remaining growth spurt. Bracing does not correct curves but holds them at an acceptable level until a person is finished growing. Bracing is never used for individuals who have finished growing. Most braces used today are low-profile and lightweight, making them more acceptable to wear than those used a generation ago.
- Surgery: For children who are still growing and have curves that measure 45 to 50 degrees, surgery is usually required. Surgery is also required in mature individuals whose curves continue to progress beyond 50 degrees, or who have significant back pain. Although surgery is rarely needed, it is a highly successful measure that both straightens the spine and prevents further progression of the curve to life-threatening magnitude.