Mark C. Lee, M.D.
Scoliosis Research Society
William A. Phillips, M.D.
Scoliosis Research Society
Scoliosis is a curve in the spine. It usually begins in early adolescence and can become larger as you grow. If the curve enlarges, it can disfigure the spine and cause breathing problems.
Fortunately, most curves do not have these dire outcomes. A screening by the child’s doctor or school nurse can find scoliosis when it is small and easily treatable. An x-ray can be done to confirm the diagnosis and plan treatment.
“For people with scoliosis, the future is bright,” said Paul Sponseller, president of the Scoliosis Research Society and professor of orthopaedic surgery at Johns Hopkins University. “We are seeing many advances that can help our patients of all ages.”
Treatment
Treatment for scoliosis depends on the curve size and the growth potential of the child. For teens with small curves who are finished growing, the curve will not get worse and needs no treatment. A growing child may be treated with a brace to prevent the curve from getting worse.
New technology allows for more comfortable wear and gives the patient feedback on how their brace wear is going. Scoliosis-specific exercises may improve the success of a bracing. If the curve is very large, surgery is an option.
Surgery
The standard surgery for scoliosis is a spine fusion with instrumentation. The abnormal, curved section of the spine is straightened and supported with metal rods. Most children recover well and return to usual activities, including sports, in three to six months.
Recent advances in technology have improved the safety of surgery. Three-dimensional computer guidance is available to improve accuracy of the surgery. Special monitoring warns if the spinal cord is at risk during surgery. New medicines decrease bleeding and make transfusion unlikely.
Future Directions
Automation will continue to advance the safety of scoliosis surgery. Someday, a robot may perform the implant placement guided by a surgeon who is not in the same room. Recent interest has grown in “non-fusion” alternatives where surgery with special implants can allow the spine to grow straighter while keeping flexibility. Genetic research may someday offer a biologic alternative to surgery.
