Scoliosis Screening of Kids Still Important

Adults no doubt recall being tested for it in school. But unless they were diagnosed with it, adults probably recall little else about scoliosis.

Though not a terribly common disorder, the fact that many school districts still test children for scoliosis indicates it's not entirely innocuous either. In fact, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), 3 to 5 out of every 1,000 children will develop spinal curves considered large enough to warrant treatment.

But what is scoliosis, what causes it and what can parents of kids with scoliosis do to ensure their kids can still lead a normal life?

What is Scoliosis?

Scoliosis is a musculoskeletal disroder in which there is a sideways curvature of the spine. While some kids with scoliosis will require treatment, others might simply need periodic observation by their physician.

Who is Most Likely to Get Scoliosis?

The most common type of scoliosis is adolescent idiopathic scoliosis, which is most likely to occur in girls over the age of 10. Research has also shown that idiopathic scoliosis can be genetic, and children who have a brother, sister or parent with idiopathic scoliosis or if any such relative has had it in the past should visit their physician regularly for checkups and examinations.

Though it is most common in children over the age of 10, it's important to note that kids younger than 10 can also develop idiopathic scoliosis. Early onset idiopathic scoliosis is more common in Europe than it is in the United States, but children younger than 3 years old can develop this disorder. When a child is between the ages of 3 and 10 and develops scoliosis, that's known as juvenile idiopathic scoliosis.

What Causes Scoliosis?

More often than not, the cause of scoliosis is unknown. In fact, NIAMS estimates that the cause of scoliosis is unknown 80 to 85 percent of the time. Physicians will look for causes such as injury or infection, and if they find curves, those curves are classified into two categories:

* Nonstructural -- A nonstructural spinal curve is temporary, and can be caused by an underlying condition such as leg length or muscle spasms. In fact, an inflammatory condition such as appendicitis can even result in a nonstructural curve. When treating a nonstructural curve, physicians treat the underlying condition and the spine then readjusts.

* Structural -- Structural curves of the spine are more serious, and can be the result of a tissue disorder or disease. Neuromuscular diseases such as cerebral palsy or muscular dystrophy can result in structural curves of the spine. Structural curves can also be the result of a birth defect such as hemivertebra, when one side of a vertebra fails to form normally before birth. Injury, metabolic diseases and rheumatic diseases can also result in structural curves of the spine.

Does Scoliosis Have to be Treated?

Each individual case of scoliosis is different, but oftentimes school screening programs are in place to shed light on a condition and determine whether or not there is a need for observation as a child continues to grow. In many cases, children who are sent to the doctor by screening programs have very mild curves that don't require treatment. If treatment is required, a child could be sent to an orthopaedic spine specialist. From there, the physician will likely recommend one of the following:

* Observation -- Because children diagnosed with scoliosis are still growing, sometimes observation is all that's necessary. If that's what's recommended, a doctor will examine the child every 4-6 months. If the idiopathic curve (the measure of the spinal curve) remains less than 25 degrees, observation will likely remain the extent of the treatment needed.

* Bracing -- When the idiopathic curve in children who are still growing is larger than 25 to 30 degrees, the doctor will likely advise a child wear a brace to keep the curve from getting any worse. When a child nears the end of his growth, the doctor will then examine the effects of the curve on the child's appearance, and also determine if the curve is getting worse.

* Surgery -- In general, doctors will recommend surgery for children who are still growing and have a curve greater than 45 degrees.

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