Scoliosis

Scoliosis usually becomes apparent during adolescence, but it sometimes develops earlier. Although the condition may correct itself as a child matures, careful monitoring and, in many cases, treatment, are necessary to avoid severe malformation. If detected early, scoliosis can be corrected without surgery in as much as 90 percent of cases.

WHAT CAUSES SCOLIOSIS?
Most cases of scoliosis are idiopathic, meaning the cause is unknown. Scoliosis is sometimes associated with disorders affecting the nerves and muscles, such as muscular dystrophy.

WHEN SHOULD I SUSPECT THAT MY CHILD HAS SCOLIOSIS?
The first indication may be difficulty getting clothes to fit properly. Hemlines don't seem to hang evenly, or one arm looks longer than the other. Most of the time, however, the condition is uncovered in a simple screening examination performed at school or in the pediatrician's office.

IS MEDICAL ATTENTION NECESSARY?
Yes. Even though immediate treatment may not be necessary, it is good idea for the child to undergo a thorough evaluation and periodic monitoring in case the condition worsens.

HOW CAN THE PEDIATRICIAN TELL IF MY CHILD HAS SCOLIOSIS?
The doctor examines the back while the child is standing and leaning over. If the ribs form a bump or the hips or shoulders appear uneven, the child probably has some degree of scoliosis. Further evaluation, usually by an orthopedic surgeon using X rays, is usually necessary to determine the extent and cause of the condition.

WHAT TREATMENTS ARE AVAILABLE?
There are four main treatment options for scoliosis: observation (for mild cases), electronic stimulation (in mild to moderate cases), bracing (in moderate to severe cases), and surgery (in severe cases).

The lightweight braces used to treat scoliosis do not hamper movement—in fact, children who wear them are encouraged to exercise. Braces can be worn for up to 24 hours a day, but some physicians prescribe part-time bracing for milder cases. On average, braces are needed for about three years or until growth slows.

In electronic stimulation, electrical impulses are transmitted to the spinal muscles during sleep, causing contractions that pull the spine back in line.

Surgery is needed in only about one out of 100 cases, usually to correct curves of 40 degrees or more. The operation generally consists of implanting metal rods to fuse the spinal column.

If scoliosis develops between birth and age three, treatment is usually unnecessary. The type of scoliosis that develops between age three and adolescence is generally more severe; in these cases, braces are ususally needed.

PREVENTING SCOLIOSIS
Even children who exercise regularly and maintain excellent posture can still develop scoliosis. Therefore, the best way to prevent damage from the condition is to detect and treat it early. Scoliosis usually can be detected in the course of a regular pediatric check-up or an in-school screen exam. Since scoliosis runs in families, parents with a family history of the condition should make a special effort to have their children checked.

GETTING HELP
Call your doctor if:

• Your child frequently sits or stands in a way that seems to favor one side of the body.

• You notice any unevenness in the level of your child's shoulder blades or hipbones.

Excerpt from THE DISNEY ENCYCLOPEDIA OF BABY & CHILD CARE, © 1995 DSH Communications, Inc. This material is based on current medical research and, to the best of the editors' knowledge and understanding, is accurate and valid. However the reader should not use information contained in this material to alter a medically prescribed regimen or as a form of self-treatment, without seeking the advice of a licensed physician.