Scoliosis Management - Orthopedic Center - Boston Children's Hospital





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Published on Jan 30, 2014

Scoliosis is a condition in which the spine—in addition to the normal front to back curvature—has an abnormal side-to-side "S-" or "C"-shaped curvature. The spine is also rotated or twisted, pulling the ribs along with it to form a multidimensional curve.

The Scoliosis Research Society defines scoliosis as a curvature of the spine measuring 10 degrees or greater on x-ray. The condition isn't rare. It mainly affects girls—many of whom have mild forms of scoliosis, are never even aware of it, and never need treatment.

Three to five children out of every 1,000 develop spinal curves that are considered large enough to require treatment. Idiopathic scoliosis does tend to run in families, although no one genetic link has been confirmed.

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Treatments can include:

Surgery: If surgery becomes necessary, our Spinal Program's orthopedic surgeons use the most advanced surgical techniques for correcting spinal problems, such as:

Spinal fusion: the most common surgical procedure for treating spinal problems
- Usually, a fusion and instrumentation are combined to correct and solidify the curve.

For younger growing children:
- Dual posterior growing rods (for early-onset scoliosis): control spinal deformity while allowing spinal growth with periodic lengthenings

- Expansion thoracostomy/VEPTR™ (titanium rib) procedure to control chest and spine deformity while permitting growth of both chest and spine vertebral stapling (a minimally-invasive surgical alternative to bracing for scoliosis in some circumstances)

- Thoracoscopic anterior spinal surgery and instrumentation

- Hemivertebra and wedge resections (for congenital scoliosis)

- Spinal osteotomy: controlled breaking or cutting and realigning of bone into a corrected correct position; may be performed when there is significant rigid deformity

- Vertebral column resection: circumferential resection of a portion of the spine to permit correction of the most severe deformities.

You can have peace of mind knowing that the team in the Children's Spinal Program has treated a large volume of spinal problems that few pediatric hospitals have seen—and can provide expert diagnosis, treatment and care. Scoliosis is not usually a life-threatening condition, and most children grow up to lead normal, active lives.


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