When is Childhood Scoliosis Treated with Bracing?

Question: My 9-year-old son has scoliosis. The doctor says the curve is mild and nothing needs to be done now. However, I'm concerned about his future. When might he need brace treatment and can you tell me more about it?
—Winston-Salem, NC

Answer: We understand your concern about your son's scoliosis and are pleased you submitted your question. Many parents share your situation and may benefit from this answer. If you are just learning about scoliosis, you might be interested to know that most cases are called adolescent idiopathic scoliosis. Idiopathic simply means the cause of scoliosis is not known. However, it is important to ask your doctor what type of scoliosis your son has. More complex types of scoliosis may require additional testing such as an MRI.
Rear view of a young boy in painAlthough scoliosis mostly affects girls, boys - like your son, can develop it too. An interesting fact is scoliosis tends to run in families. So if a relative has (or had) scoliosis, you should share that with your son's doctor. You will be pleased to know that in adolescents, scoliosis is usually painless. Plus, most young patients continue to play sports, swim, dance, and other fun physical activities.

Diagnosing Scoliosis
One of the first steps to diagnose scoliosis is a full-length X-ray of your son's spine. These X-ray studies include front, back and side views of the spine. Special X-ray film allows the doctor to see the spine from the head to the hips. Next, the doctor measures the degree of the curve. Adolescent curves less than 20-degrees are watched. Every 4 to 6 months new X-rays are performed and the curve is measured again and checked for changes.

About Curves and Braces
Adolescent curves greater than 20-degress, but less than 40-degrees may need brace treatment. This is because the child is not skeletally mature and the spine is still growing. Brace wear instructions may vary among spine specialists. Some doctors prescribe a night brace and others advise brace wear 23-hours per day. Just as there are different types of scoliosis, there are different braces. Usually an Orthotist is involved to design and fit the brace to the patient. Bracing doesn't necessarily correct the curve but stops it from progressing.

Sometimes bracing doesn't work. Adolescent curves greater than 40- to 45-degrees, or those that fail brace treatment, may need surgical correction. However, your son's case is mild and his curve may not progress to the point of even needing brace treatment! So, for now, just take it one follow-up appointment at a time.

Other Help
There are many doctors who specialize in treating scoliosis. You did not mention if your son's pediatrician made the diagnosis and if you have consulted with a spine specialist. However, if you want to see a spine specialist, or obtain a second opinion, please feel free to use "Find a Specialist" at SpineUniverse.com. Of course, your son's pediatrician is a good referral resource.