Scoliosis in kids: What you need to know
A sideways curvature of the spine affects 2 to 3 per cent of the population
It’s common and often goes unnoticed in young kids. However, scoliosis – or a sideways curvature of the spine – affects almost 2 to 3 per cent of the population.
What happens what someone has scoliosis?
Usually nothing. It’s often so mild that you can’t really tell – except for an unequal standing of the shoulders or lopsided hips. But what could happen is, explains Dr Antony Louis Rex Michael, Consultant Orthopaedic Spine Surgeon with Neurospinal Hospital, that the curvature of the backbone could cause a rotation of the vertebrae. The unnatural bending then can make the channel of bones look like an ‘S’ or a ‘C’ instead of its usual straight line.
What are the different types of scoliosis?
US-based Cleveland Clinic explains that there are three types of paediatric and adolescent scoliosis:
Idiopathic scoliosis. This is the most common type. ‘Idiopathic’ means that the cause is unknown, but because it runs in families, it has a genetic basis.
Congenital scoliosis. This is a fairly rare spine abnormality detected at birth.
Neuromuscular scoliosis. This is a curvature of the spine caused by abnormalities in the muscles and nerves that support the spine. Examples include patients with cerebral palsy, spina bifida and muscular dystrophy.
What causes scoliosis?
Dr Louis Rex Michael says, “There are several causes of scoliosis. The cause of the commonest type called 'idiopathic scoliosis' is unknown though several theories exist. Other forms of scoliosis are caused by neuromuscular issues, for example, cerebral palsy; syndromes related to neuromuscular imbalance; congenital malformations of the vertebrae, etc.”
There are several causes of scoliosis. The cause of the commonest type called 'idiopathic scoliosis' is unknown though several theories exist.
What tests help a doctor determine the patient has the condition?
There are a number of tests that must be conducted to conclude that a patient has the condition and to decipher the severity of it. SpineUniverse, an online resource dedicated to spine education, explains the tests as physical and imaging-based.
Physical tests:
- Forward bend test: Your doctor may also use this test to see the abnormal curve.
- Plumb line test: This is a quick visual check to see if the spine is straight. In scoliosis, the plumb line will fall to the left or right of the spine instead of through the middle of the buttocks.
- Scoliometer: If the doctor sees a rib hump, he or she can use a scoliometer tool to measure the size of the hump. It's a painless and non-invasive test.
- Leg length: Legs are measured and compared to determine discrepancy.
- Palpation: Your doctor will determine spinal abnormalities by feel. The ribs or lumbar muscles may feel more prominent on one side of the spine than the other.
- Range of motion: Your doctor will measure the degree to which your child can perform movements of flexion, extension, lateral bending, and spinal rotation. The doctor also notes asymmetry.
In addition to the physical evaluation, your doctor would perform a neurological examination, states the website. The purpose is to notate areas of numbness, tingling, weakness, and other neurological symptoms, which may include changes in bowel or bladder function.
Imaging tests
Two views are typically taken in x-rays for scoliosis to illustrate the full nature of the curve, it adds:
- PA (posterior-anterior, or back to front) and lateral (side) x-rays.
- Side bending AP (anterior-posterior, or front to back) x-rays assess spinal flexibility.
Are girls or boys more likely to get idiopathic scoliosis?
Idiopathic scoliosis is more common in girls, says Dr Louis Rex Michael.
What is the treatment for scoliosis?
He says: “The treatment depends on the severity of the scoliosis at time of diagnosis and the underlying cause. Earlier diagnosis allows treatment with braces (orthosis) and physical therapy. Late diagnosis and severe curves (over 50 degrees) may require surgical correction and fusion of the affected vertebrae. Newer non-fusion surgical options are now gaining increasing recognition. This includes vertebral body tethering."
If your child needs surgery – what is the recovery time?
Dr Louis Rex Michael explains that recovery from surgery is approximately 8 to 12 weeks though time in hospital is around one or two weeks depending on the severity and type of surgery.
Source: John Hopkins Medicine, US
What does aftercare look like?
“Aftercare from surgery focuses on pain management and rehabilitation in the early period and maximising function in the later stages. Follow up with X-Rays is important to tailor rehabilitation and activity,” he adds.
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