Scoliosis Care

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Scoliosis Treatments

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Our award-winning, internationally recognized physicians treat more than 10,000 children with scoliosis each year.

In the United States, 2% to 5% of children develop scoliosis, where the spine curves to make a C shape or S shape, rather than growing in a straight line. Over time, the curve can worsen, making it more noticeable and causing pain. In instances where the curve of the spine is more severe and is left untreated, it has the potential to impact the heart, lungs and other internal organs as they grow and become more crowded.

Diagnosing scoliosis in children is fairly straightforward. If an X-ray shows a spine curvature of 10 degrees or greater, the next step is to meet with a doctor who specializes in pediatric orthopedics for an examination.

Our philosophy is to consider all of the options for your child. This ranges from scoliosis-specific exercise therapy and Mehta casting, to the most advanced surgical treatments, such as the MAGEC System for guided growth of the spine, vertebral body tethering and spinal fusion. Together we’ll create a treatment plan that is the best fit for your child’s age, the severity of their condition, and the activities they love.

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Scoliosis overview with Dr. Steven Hwang

Dr. Hwang from Shriners Children’s Philadelphia gives us a quick overview of scoliosis. Shriners Children’s treats scoliosis at 20 locations across the country including our Montreal, Canada and Mexico City, Mexico locations.

View Transcript

Dr. Steven Hwang:

Hi, my name's Steven Hwang. I'm one of the spine surgeons here at Shriners in Philadelphia. We treat primarily scoliosis in children here. And so scoliosis is essentially a three-dimensional rotation of the spine. And so we often see with a curvature in children, may notice some shoulder symmetry or sometimes a rib prominence in the back. Sometimes their waist may be to the side a little bit. You yourself, or your children may have noticed screening in schools or by the pediatricians. Often they have children lean forward and look at their backs to look for any of these asymmetries to help identify those children who have scoliosis. And so a lot of those children come to us here and we help manage them in different ways.

There's a lot of different options to help treat these children. I think you've heard from some of the children today. Some involve traction and surgeries or different kinds of bracing methods. And we do treat kind of the gamut of options here at Shriners in Philadelphia. And so thank you very much for helping us treat these children and help these other children. We do really appreciate all the help we have and the resources, and it helps us help others as well.

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A diagnosis of scoliosis can be stressful for the entire family. Those stressors can include fears about your child's future and insecurity about making the right decisions. Be reassured that if your child is diagnosed with scoliosis, you'll have a Shriners Children's care team to guide you. Your child’s surgeons, physical and occupational therapists, and other care providers understand the concerns of children and parents navigating this journey.

We’ve seen children with scoliosis successfully progress through childhood, as they become active preschoolers, elementary school gymnasts, and teens confidently socializing with friends and succeeding in sports. Here you can learn more about pediatric scoliosis and the treatment options that are available.

Specific treatments and services may vary by location. Please contact a specific location for more information.

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Learn About Scoliosis Treatments

When you and your child meet our scoliosis treatment team, you’ll discover we're always moving forward. Our physicians stay active in the medical community, continue their training and eagerly incorporate the latest evidence-based treatments for scoliosis into their practices. Often it is our own physicians developing the methods for these treatments, while working in partnership with the FDA and industry partners.

Every scoliosis treatment plan is as unique as your child. Read about all the scoliosis treatment options here and several of the most common below.

Observation

Sometimes the best treatment is time. Your child’s doctor will talk to you about the measurement of the curve in their spine and what that measurement means for his or her treatment. If the curve measures less than 20 degrees, our spine team will examine your child and take low-dose X-rays every four to six months during their growing years to see how the curve is changing (also called curve progression). In most cases, if the curve is not progressing, your child will not need treatment.

Scoliosis-specific Exercises

If your child does not wear a back brace, they may safely perform scoliosis-specific exercises. They'll be shown how to do them by our trained and certified therapists, learning individualized exercises to improve the alignment of their posture and minimize the progression of the spinal curvature. They'll perform these exercises daily to increase their strength and maintain the correction. This approach addresses the 3-D characteristics of scoliosis and is based on the Schroth Method.

Mehta Casting

Mehta casting is an option for children typically between 6 months and 5 years, and it can be used instead of bracing. Casting is often used to delay or prevent the need for surgery.

A Mehta cast is a plaster cast applied from a child’s collarbone to the bottom of their spine. Once the cast hardens, it holds the spine in position by applying gentle pressure. Children need a new cast every two to three months, with each one straightening the spine a bit more. Some children may transition to a brace as they get older.

Bracing

Our orthopedic physicians may recommend a brace if the curve is moderate (between 25 and 40 degrees) or if it is progressing. The brace will need to be worn until your child stops growing or until their doctors recommend a different type of treatment. It's important to note that bracing is not always effective and sometimes the curve increases anyway. In this instance, surgery may be necessary.

Halo Traction

This is a unique form of treatment for severe cases of scoliosis, offered at a limited number of pediatric hospitals in the United States. Shriners Children’s is finding excellent results with halo traction, an inpatient treatment option.

The halo is a ring device held in place on a child’s skull using several pins. It is held upright through a pulley system attached to a bed, a wheelchair or walker. A child’s head is lifted upward to lengthen the spine and stretch out surrounding soft tissue. By stretching the spine, there is an increase in the vertical height of a child's chest, which improves lung capacity and breathing.

On average, patients see a correction of 35% or more after three to four weeks in traction. A halo treatment is followed by spinal correction surgery to maintain this significant improvement. A team of child life specialists, physical/occupational therapists and other members of the care team partner with our surgeons during a child’s long-term stay at Shriners Children's for the halo process. The result is often life-changing.

Growing Rods

During a scoliosis surgery, two telescoping rods are inserted through the back and attached to the spine above and below the curve, with hooks or screws. Children return for treatment every six months to have the rods lengthened to match their growth. With a growing rods treatment, the spine continues to grow while being guided by the rods to create better alignment of the spine.

MAGEC Rods

The MAGEC (MAGnetic Expansion Control) Spinal Bracing and Distraction System is composed of two magnetic, telescoping rods that are gradually lengthened from outside of the skin using a magnet. This pioneering procedure for young children with scoliosis helps reduce the number of surgeries they may experience during childhood, which decreases their exposure to general anesthesia and limits the number of scoliosis surgeries they would experience over several years.

Vertebral Body Tethering

Our pediatric spine surgeons are leading the way in this treatment. The Vertebral Body Tethering System differs from a typical scoliosis surgery called a “spinal fusion,” which involves implanting stiff metal rods along either side of a child’s spine to straighten the curve.

Rather than stiff metal rods, The Tether™ uses a strong, flexible cord attached to the spine. When the vertebrae are pulled by the cord, it puts pressure on the tall side of the vertebrae on the outside of the curve. This pressure slows the growth on the tall side of the vertebrae, so that the short side can grow and catch up. The system permanently straightens the spine using a child’s own growth process. Unlike spinal fusion, the spine is still able to bend and flex, rather than being fixed in place with the stiff metal rods.

Spinal Fusion Surgery

The goal of this surgery is to fuse the spine, correcting the spine curvature and preventing further progression. Fusion surgery involves attaching rods, hooks, wires or screws to the curve and placing small pieces of bone over the spine. The bone pieces (taken from the child during surgery or donated) will grow together with the child's spinal bone, fusing it in the proper position. Although the spine may not be made completely straight, the curve will be less than it was before surgery.

A surgeon may recommended spinal fusion for a child who is at least 10 years old with a curve greater than 45 degrees and increasing; or for a child whose curve is greater than 50 degrees once they have finished growing.

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Symptoms of Scoliosis

Your child’s pediatrician or their school nurse may have been the first to screen for scoliosis in school or notice the curve in your child’s spine. As your child continues to grow, you can look for other scoliosis symptoms to share with their pediatrician and orthopedic specialist. Pay special attention during their teen years when growth spurts are common. Look for symptoms like:

Leaning to one side
One shoulder appearing higher than the other
One shoulder blade sticking out farther than the other
One hip appearing higher than the other
Head appearing not properly centered over the body
When bending from the waist, the ribs on one side are higher
Waistline appearing flat on one side
Clothes not fitting correctly
Hems that aren’t hanging evenly

Talk to us about anything you’ve noticed or have questions about. Once your child is a Shriners Children's patient, we’ll keep a close eye on them, too, with X-rays and other imaging as needed.

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Types of Scoliosis and Their Causes

As you interact with your child’s team of physicians, surgeons and physical therapists, you may hear them refer to your child’s condition in one of these ways:

Idiopathic scoliosis: the most common type of scoliosis. In these cases, the cause is unknown.

Idiopathic infantile scoliosis: occurs in children under 3; they can be born with the curvature or it may develop as they grow.

Idiopathic juvenile scoliosis: affects children between 3 and 10.

Idiopathic adolescent scoliosis: generally occurs in children 10 and older; girls are more likely than boys to develop idiopathic scoliosis.

Congenital scoliosis: occurs when the vertebrae don’t form in a typical way during pregnancy.

Neuromuscular scoliosis: can occur at any age. The scoliosis is caused by a neuromuscular condition, such as spina bifida, cerebral palsy or muscular dystrophy.

Syndromic scoliosis: occurs when a curve of the spine develops at any age as part of a syndrome, such as Marfan syndrome and Ehlers-Danlos syndrome, Down syndrome (trisomy 21), Prader-Willi, Retts syndrome and Beale’s syndrome.

Causes of Childhood Scoliosis

As a parent, you may wonder if you could have done anything to prevent scoliosis in your child. In about 80% of cases, the cause is unknown (described as idiopathic scoliosis). There’s likely a genetic factor, meaning the risk of a child developing it can be passed from a parent or previous generation; we're studying the genetic relationship at our Genomics Institute in Tampa, Florida. Other causes of scoliosis include muscle diseases (such as cerebral palsy, spina bifida or muscular dystrophy), birth defects in the development of the spine during pregnancy and spinal cord injuries.

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Everyone at Shriners did a really good job at keeping me informed. Knowing all of the details of the procedure was super calming to me.
Rachel, Portland

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Louis","image":"https://edge.sitecorecloud.io/shrinershosf393-shriners4ad9-prodb963-58d8/media/project/shriners/shc/migration-images/related-locations-dropdown-carousel/st-louis-hospital-exterior-961x640-298-ashx.jpeg?h=640&iar=0&w=961","imageAlt":"st-louis-hospital-exterior-961x640-298-ashx","text":"Pediatric specialty care for children throughout Missouri and beyond","ctaItem":{"ctaLinkIcon":"https://edge.sitecorecloud.io/shrinershosf393-shriners4ad9-prodb963-58d8/media/icons/si-nonhero-icons-_-24x24px/solid-white-_-24x24px/mappin_24x24_whitesolid.svg?iar=0","ctaLinkText":"More About This Location","ctaLink":"https://www.shrinerschildrens.org/en/locations/st-louis"},"itemId":"https://www.shrinerschildrens.org/en/locations/st-louis"},{"title":"Shriners Children's 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physician using MAGEC expander tool on patient's back

The MAGEC System for Guided Bone Growth

With surgery, one or two telescoping MAGEC rods are attached to the child's spine. As your child grows, we use a magnet controller outside of their body to lengthen the rods and ultimately straighten their spine. The treatment isn't painful and requires no rehabilitation.

Learn about the MAGEC treatment

Innovative Treatments

Scoliosis Specific Exercises

Scoliosis specific exercises offered by physical therapists at Shriners Children’s aim to correct and slow the progression of a spinal curve, reduce pain and improve posture, breathing and quality of life.

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Mehta Casting

Shriners Children's orthopedic surgeons specialize in the application of Mehta casts – an option to treat the curvature of the spine in children diagnosed with infantile scoliosis.

Bracing

Shriners Children's multidisciplinary team includes orthotists who create braces to meet the individual need of each child – whether to treat a complex condition or common injury.

Halo Traction

Shriners Children's skilled physicians use halo traction as a first step in correcting severe scoliosis, kyphosis and other spine deformities. The treatment carefully pulls a child's head and spine upward, applying a slow stretch.

Growing Rods

Shriners Children's provides growing rods for children who have not reached skeletal maturity. They are placed along the spine to correct a spinal curve and allow continued growth of the spine.

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MAGEC System

Shriners Children’s pioneered the use of the MAGEC System for treating early onset scoliosis. This magnetic rod-lengthening treatment gently guides the growth of the spine, without repeated surgeries.

Spinal Fusion Surgery

Spinal fusion surgery stabilizes and corrects the curvature of the spine; and for scoliosis and kyphosis, prevents further curvature of the spine. Stabilizing the spine can improve movement, reduce pain and restore lung function.

Next Steps

Request an Appointment

Families and caregivers seeking treatment should start by contacting us for an appointment.

Get Started

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Log in to the Patient Portal

Parents and guardians of existing patients can email, request records, schedule appointments and more.

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Refer a Patient

Physicians and healthcare providers can request appointments, start transfers or contact us with questions.

Send Referral

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Scoliosis Care

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Our award-winning, internationally recognized physicians treat more than 10,000 children with scoliosis each year.

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Scoliosis overview with Dr. Steven Hwang

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Observation

Scoliosis-specific Exercises

Mehta Casting

Bracing

Halo Traction

Growing Rods

MAGEC Rods

Vertebral Body Tethering

Spinal Fusion Surgery

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Causes of Childhood Scoliosis

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Locations for Scoliosis care

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The MAGEC System for Guided Bone Growth

Innovative Treatments

Scoliosis Specific Exercises

Mehta Casting

Bracing

Halo Traction

Growing Rods

MAGEC System

Spinal Fusion Surgery

related from shriners children's

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Next Steps

Request an Appointment

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Log in to the Patient Portal

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Refer a Patient

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Our award-winning, internationally recognized physicians treat more than 10,000 children with scoliosis each year.

Scoliosis overview with Dr. Steven Hwang

Observation

Scoliosis-specific Exercises

Mehta Casting

Bracing

Halo Traction

Growing Rods

MAGEC Rods

Vertebral Body Tethering

Spinal Fusion Surgery

Causes of Childhood Scoliosis

Request an Appointment

Log in to the Patient Portal

Refer a Patient