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Scoliosis

Adolescent & Juvenile Scoliosis Fundamentals

In scoliosis, the spine curves from side to side. In most cases, the cause of scoliosis is unknown. Both boys and girls develop scoliosis, but girls are four times more likely to require surgery than boys.

The condition develops gradually, typically between the ages of 10 and 16, and may progress during your child’s growth spurt years. Scoliosis is painless and easy to miss, but can become apparent during a routine physical exam. Adolescents are always screened for scoliosis, whether by a school nurse or the family doctor.

Diagnosis involves a look at medical and family history, and a physical and neurological exam. If a curve is detected, X-rays are used to pinpoint the location, extent and degree of curvature.

What are the symptoms of scoliosis?

  • Uneven shoulders or waistline
  • One or both shoulder blades sticking out
  • Leaning slightly to one side
  • A hump on one side of the back

What are my child’s treatment options for scoliosis?

Treatment depends on your child’s age, bone maturity and the degree and pattern of the curve.

Medical

Bracing is used to temporarily halt the worsening of the curve during a growth spurt. The braces are lightweight and typically only need to be worn at night.

Surgical

If the curve is more than 45 degrees, surgery is the only permanent solution. The goal of surgery is to make the spine straighter. The surgeon fuses the bones of the spine together with the help of bone grafts and uses metallic implants to strengthen that bond.

In some cases, surgeons use a less invasive technique. Guided by a thin, telescope-like instrument called an endoscope, they can place metal implants and bone grafts in the spine through small incisions in the abdomen and chest. With this approach, the incision is shorter, recovery is easier, and most patients can leave the hospital after two or three days.

What are the risks of surgery?

Risks include nerve injury, infection and bleeding.

How does my child prepare for surgery?

  • Complete any pre-operative tests or lab work prescribed by your child’s doctor.
  • Do not allow your child to take aspirin and non-steroidal anti-inflammatory medications (NSAIDs) one week prior to surgery.
  • Call your doctor’s office to verify the surgery time.
  • Refrain from eating or drinking anything after midnight the night before surgery.

What does my child need to do the day of surgery?

  • If your child currently takes any medications, please check with the doctor’s office before taking them.
  • Do not allow your child to wear any jewelry, body piercing, makeup, nail polish, hairpins or contacts.

What happens after surgery?

Surgery immediately makes the spine straighter, so there is usually no need for bracing afterward. The surgery will permanently stiffen the spine, but mobility and function will not usually be affected.

Ask your surgeon for complete post-operative instructions.

How long is the recovery period after surgery?

After six weeks of recovery, the child may return to school, then to walking-level activities for three months. The child may return to recreational activities and sports as the physician advises. Patients who undergo scoliosis surgery typically must wait one year before returning to sports.

What is the rehab after surgery?

Rehabilitation involves a gradual return to walking-level activities. The child may swim and return to school after six weeks. Typically, no physical therapy is needed.

How will my child manage at home during recovery from scoliosis surgery?

Patients can resume normal activity at home. They may take showers five days after the procedure.

How frequently should I schedule follow-up appointments with my child’s doctor following surgery?

The child’s first post-operative visit typically takes place four to six weeks after the procedure. A second appointment takes place three months after the procedure.

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This information is provided by Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition.

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