Tag: scoliosis in children

I think my Child has Scoliosis – 3 things NOT to do

Posted on April 14, 2022 by - Blog

As parents, we all want to do the best for our children – and when you suspect Scoliosis it can be hard to know what to do. Despite efforts from the Scoliosis community the condition is still widely unknown in the general population which can lead to confusion and that feeling of not knowing where to turn. The most important step to take if you do suspect scoliosis is simply to get active – reach out for help and get the ball rolling.

There are however, a few things you should definitely not do – these three issues are, in our experience the biggest pitfalls for parents of children with scoliosis, so wherever possible do not:

 

1 – Be passive

Because Scoliosis is a lesser known condition, you may well not know anyone who has suffered with the condition. The reality is that Scoliosis should be treated as quickly as possible, as treatment is much easier with a smaller curve, however the lack of awareness in the community can lead to a false sense of lack of urgency. Even amongst those who do know about Scoliosis, many are still unaware that new, non-surgical treatment options now exist. 10- 15 years ago, it was thought that surgery was the only effective option for treating scoliosis, so even many medical professionals were simply taught that the best approach to scoliosis is to “wait and see” if the curve becomes bad enough for treatment. The problem is that scoliosis almost never resolves on its own[1] so while it’s possible it may not progress further “wait and see” is never a good option – at the very least see a scoliosis specialist and ensure the condition is being monitored.

 

2 – Ignore the costs

Unfortunately, very little non-surgical Scoliosis treatment is available in the UK through the NHS. This means that if you’re looking for non-surgical treatment, you’ll probably be taking about private care. Please do see your GP to find out what is available in your area, but you should expect that Scoliosis treatment will cost you money.

It’s easy to react to these costs by either ignoring them (which isn’t responsible) or failing to contextualise them properly (which isn’t realistic). There are two major factors to consider here. Firstly, if you are seeking help for a scoliosis case which is already severe, the chances for successful treatment without surgery are lower – the larger the existing curve, the higher the chance non-surgical approaches will fail. A reputable scoliosis practitioner will give you the best indication they can as to the possible outcomes of treatment and what you might expect in a best or worst case scenario – you should base your decision on the cost of treatment on your own expectations for outcomes, and how likely they are. In some cases, you may be paying simply to delay surgery which will be required anyway and this is important to remember.

At the other end of the scale, it’s critical to remember that Scoliosis treatment is a long process – the totality of your scoliosis treatment will extend from discovery of the condition through until your child has reached adulthood – it’s therefore essential to remember that the costs for treatment are spread over a very long period of time. The price of a Scoliosis brace, for example, is therefore best considered as a monthly one over duration of the brace, rather than a single one off cost.

 

3 – Forget about mental health

Scoliosis can be stressful for everyone involved – and since it’s a condition which commonly affects teens and young adults, it comes at a time of life which is already delicate for many. There are two main approaches to scoliosis treatment plans to choose from – one is group based treatment, and one is individual treatment. Group based settings offer no privacy, but can potentially foster a ready made support group, whereas private one to one settings offer privacy without peer support.

The right kind of environment for you will of course depend on your own child’s preferences – so try to keep this in mind when choosing a clinic. At the UK Scoliosis clinic, we provide a private one to one environment, although we welcome as many relatives or friends that your child would like to have around them to attend consultations, exercise sessions and treatment reviews. Research has shown that having a calming and private environment to discuss and perform treatment can actually lead to better clinical outcomes, although this won’t be ideal for every child. [2]

 

Getting help

If you’re concerned about Scoliosis, please don’t hesitate to get in touch with us – we offer Scoliosis consultations online as well as at the clinic with no obligation to take up treatment, whatever you do – be active!

 

 

[1] Angelo G Aulisa et al. ‘Brace treatment in juvenile idiopathic scoliosis: a prospective study in accordance with the SRS criteria for bracing studies – SOSORT award 2013 winner, Scoliosis 2014 9:3

[2] Elisabetta D’Agata et al. Introversion, the prevalent trait of adolescents with idiopathic scoliosis: an observational study Scoliosis and Spinal Disorders (2017) 12:27

Scoliosis awareness month – Early-onset Scoliosis

Posted on June 7, 2021 by - Blog

Early-onset Scoliosis is an umbrella term used by many organisations (including the scoliosis research society) to include scoliosis cases that present under the age of 10. Within this bracket, there are really two further categories of scoliosis we need to understand.

The first is Infantile scoliosis – which is the name given to scoliosis cases that are diagnosed in children between the ages of 0 to 3 years. Infantile Scoliosis is at least as common in boys as girls, which is worth bearing in mind since adolescent cases (which comprise the majority of overall cases) are predominantly female cases[1].

Juvenile scoliosis is therefore diagnosed when scoliosis of the spine is apparent between the ages of 4 and 10. It is less common than adolescent scoliosis and comprises about 10-15% of total idiopathic scoliosis cases.  It is found more often in boys between the ages of 4-6 and curves tend to be left-sided, while in older children it is more common in girls and curves are right-sided and similar to adolescent scoliosis.[2]

 

What causes early-onset Scoliosis?

There are several main categories that comprise early-onset scoliosis cases – these are:

  • Idiopathic – Curves for which there is no apparent cause – this is probably the kind of scoliosis you are most familiar with, as it forms the bulk of scoliosis cases, especially in teens.
  • Congenital – Here the cause is incorrect development of the Vertebrae in-utero. It is sometimes associated with cardiac and renal abnormalities.
  • Neuromuscular – In children with neuromuscular disorders including spinal muscular atrophy, cerebral palsy, spina bifida and brain or spinal cord injury.
  • Syndromic – Certain syndromes, such as Marfan’s, Ehlers-Danlos and other connective tissue disorders, as well as neurofibromatosis, Prader-Willi, and many bone dysplasias may be associated with EOS.

At the UK Scoliosis clinic, we mainly focus on the treatment of the idiopathic variety – which, as the name implies, is currently without defined cause. There are two main theories that explain the development of idiopathic infantile scoliosis – the first postulates that some children are simply born with a spine that is already curved, while the second suggests that the curvature occurs after birth and may be linked to the way a baby is handled. Much more research is required to clarify this, however.

 

What is the prognosis for early-onset Scoliosis?

The Scoliosis research society notes especially for early-onset cases, that early Scoliosis carries a risk of heart and lung problems in childhood which may become increasingly problematic in adult years[3] – but it’s worth noting that other research has shown that scoliosis can negatively impact the heart and lungs as the deformity increases in other age categories[4]. When untreated, severe EOS may be associated with an increased risk of early death due to heart and lung disease – the term Thoracic Insufficiency Syndrome (TIS) is commonly used to describe the potential combined spine and lung problems in EOS.

Idiopathic scoliosis has a number of possible treatment pathways, both non-surgical and surgical, whereas congenital and syndromic cases are more complex, and require in-depth evaluation to determine the best pathway. In all instances, it is important that suspected cases in infants should be investigated with a complete neurological examination and MRI or CT scan. This will serve to rule out any underlying neurological condition or disease process and allow the best treatment to be given as soon as possible.

 

How can we treat early-onset scoliosis?

Bracing may be an effective approach in idiopathic cases with good flexibility in the curve – however, rigid curves are less likely to benefit from this approach. Casting (which is a similar approach, using a plaster cast rather than a brace) is also a possible approach here.

Early-onset scoliosis is, however, the only broad category of scoliosis where the “wait and see” approach may have some value. The Scoliosis research society guidelines suggest that Idiopathic early onset scoliosis with curves greater than 30-35 degrees are most likely to progress and some studies have suggested the progression to surgical threshold for this group may be as high as 100%[5] – however, children younger than age 2 with infantile idiopathic curves less than 35 degrees stand a chance of the condition resolving without further treatment.

 

What does early-onset Scoliosis look like?

The below X-ray shows an example early onset Scoliosis case. It’s usually not possible to tell how severe scoliosis is without taking an X-ray, although external signs can suggest that the condition may be present. This is why regular screening is so important!

 

 

 

[1] https://www.srs.org/patients-and-families/conditions-and-treatments/parents/scoliosis/early-onset-scoliosis/infantile-idiopathic-scoliosis

[2] https://www.srs.org/patients-and-families/conditions-and-treatments/parents/scoliosis/early-onset-scoliosis/juvenile-idiopathic-scoliosis

[3] https://www.srs.org/patients-and-families/conditions-and-treatments/parents/scoliosis/early-onset-scoliosis

[4] Sperandio EF, Alexandre AS, Yi LC, et al. Functional aerobic exercise capacity limitation in adolescent idio- pathic scoliosis. Spine J. 2014;14(10):2366–72. PubMed doi:10.1016/j.spinee.2014.01.041

Sperandio EF, Vidotto MC, Alexandre AS, Yi LC, Gotfryd AO, Dourado VZ. Exercise capacity, lung function and chest wall shape in patients with adolescent idiopathic scoliosis. Fisioter Mov. 2015;28(3):563–72. doi:10.1590/0103-5150.028.003.AO15

Barrios C, Pérez-Encinas C, Maruenda JI, Laguía M. Significant ventilatory functional restriction in adoles- cents with mild or moderate scoliosis during maximal exercise tolerance test. Spine. 2005;30(14):1610–5. doi:10.1097/01.brs.0000169447.55556.01

 

[5] Progression risk of idiopathic juvenile scoliosis during pubertal growth, Charles YP, Daures JP, de Rosa V, Diméglio A. Spine 2006 Aug 1;31(17):1933-42.