Schools screen for scoliosis
by Dr. Styles Bertrand
Many schools regularly screen middle school students for scoliosis. If your child receives a referral for scoliosis based on a school screening, here are some facts you should know.
What is scoliosis?
Scoliosis is a sideways curvature of the spine that makes the spine look more like an "S" or "C" than a straight "I". Bones of the spine may turn so that one shoulder, shoulder blade or hip appears higher than the other. Left untreated, scoliosis exceeding 50 degrees can lead to diminished lung capacity, restrictive lung disease and cosmetic concerns.
Scoliosis can run in families, but the exact cause is unknown. It can occur at any age, but the most common type, adolescent idiopathic scoliosis, occurs after age 10.
Adolescent idiopathic scoliosis is usually painless. Small curves occur with similar frequency in boys and girls, but girls are more likely to have a progressive curve requiring treatment.
Diagnosis of scoliosis requires a thorough medical history and comprehensive physical examination to determine if other problems may be causing the spine to curve. The physician will ask your child to bend forward, which will show any deformities, and check for limb-length discrepancies, abdominal muscle strain and other potential causes. The curve is confirmed with a spine X-ray, from which the degree of curve can be measured.
Treatment options
Treatment depends on the type and size of the curve and your child's age.
- If the curve is mild (less than 25 degrees) or your child is near
skeletal maturity, observation is the appropriate option. The
doctor will recheck the curve regularly to ensure it doesn’t worsen. You
may be asked to return every three to six months for re-examination.
Most cases of scoliosis referred through school screening fall into this
category.
- Bracing, intended to keep curves from worsening, can be
effective if your child is still growing and has a 25- to 45-degree
curvature. Most braces are made of thin plastic and extend from under
the arms to above the hips. Your orthopedist will recommend the type of
brace and how long to wear it each day. A brace can be taken off for
sports activities.
- If the curve exceeds 45 degrees and your child is still growing, or the curve exceeds 50-55 degrees, surgery requiring a bone graft from the hip, ribs or a bone bank may be necessary. Rods, hooks, screws or wires are used to straighten the spine. Patients generally walk without a brace by the second or third day after surgery and leave the hospital within a week. Daily activities can be rapidly resumed and a return to sports is allowed after six to 12 months.
If your child’s school does not offer screenings, talk to your pediatrician. Early detection and treatment of scoliosis is important to preclude long-term effects.
― Dr. Bertrand is a pediatric orthopedic surgeon with MCG Health System.