A musculoskeletal condition, scoliosis affects the spine and, specifically, the vertebrae that make up the spine. A normal spine appears—when viewed from a certain angle—as a straight line front-to-back, even though there are normal curves and bends present. But a spine afflicted with scoliosis will display an abnormal side-to-side curvature that may resemble the shape of a letter C or S. Pediatric idiopathic scoliosis manifests—as the name suggests—during childhood and before the body has finished growing, generally before the age of 18.
To arrive at a diagnosis of pediatric idiopathic scoliosis, a physician will likely take a multi-phase approach to rule out other types of scoliosis. This approach begins with a study of the patient’s medical history to seek any unknown and underlying cause that may be the origin of the spinal curvature. A physical exam is also crucial to the diagnostic process, during which a physician will: check to see if the shoulders and rib cage are uneven (one side higher than the other); if the patient’s head is centered over the spinal column; if their pelvis is tilted; and if there is a general lack of symmetry between the two sides of the patient’s body.
Imaging studies are used in conjunction with the physical exam, including x-rays, CT scans and MRIs, all of which, when used together, can determine the angle of spinal curvature; what conditions may be causing the curve; and the exact location and shape of the curve. And the results of testing often dictate the course of treatment: if the curve is not severe (less than 20 degrees), no treatment will be needed but monitoring will be recommended; in other cases both surgical and non-surgical options will be considered in order to correct the curve and/or keep the curve from worsening.
Non-surgical treatments for pediatric idiopathic scoliosis include the application of a physical bracing device to stop the curve from worsening and physical therapy to strengthen the muscles of the back and encourage a healthy range of motion. When surgery is required—typically if the curve reaches a point of 50 degrees and is getting more severe—a doctor may perform a spinal fusion or implant rods to stabilize the spine and prevent a worsening of the curve.
Although, in recent years, alternative methods for treating pediatric idiopathic have become more prominent—yoga, chiropractic treatments etc.—they have not demonstrated the ability to correct spinal curvature or prevent the curve from worsening, but may be of some benefit in relief of physical symptoms.