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How we'll treat your child's scoliosis depends on the complexity and severity of her condition. Boston Children's Hospital's Spinal Program provides comprehensive treatment—including evaluation, diagnosis, consultation and follow-up care.
At Boston Children’s Spinal Program, we’re known for our clinical innovations, research and leadership. As a world center for the treatment of scoliosis, we offer the most advanced diagnostics and treatments—several of which were pioneered and developed by our researchers and clinicians.
Once an abnormal spine curve has been detected, it's important to monitor the curve as your child grows. In many cases, your child's curve may require only close monitoring during skeletal growth. Your Boston Children's physician will determine your treatment plan and follow-up based on your child's x-rays and physical exams.
Scoliosis can often be helped by physical therapy. Our physical therapy team's goal is to maximize your child's physical functioning. Our therapists work closely with the Spinal Program to also provide exercise programs and additional therapies to address pain and the muscular imbalance that can be associated with spinal abnormalities.
If your growing child's curve shows significant worsening or is already greater than 30 degrees, your physician may recommend a bracing program, in which a scoliosis brace is designed specifically for your child's particular curve. The brace holds your child's spine in a straighter position while she is growing in order to partly correct the curve or prevent it from increasing. A bracing program may help avoid surgery.
In certain situations—as in some cases of early-onset (infantile) idiopathic scoliosis—body casting is indicated.
If surgery becomes necessary, our Spinal Program's orthopedic surgeons use the most advanced surgical techniques for correcting spinal problems, such as:
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:
• 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)
• MAGEC (MAGnetic Expansion Control) System, an adjustable growing rod system that uses magnetic technology and
a remote control to non-invasively lengthen the device
Controlled breaking or cutting and realigning of bone into a corrected position; may be performed when there is significant rigid deformity
Circumferential resection of a portion of the spine to permit correction of the most severe deformities
Your Boston Children's orthopedist will make treatment determinations depending on your child's age, the type and progression rate of her curve, the prediction of further curve progression and other factors. Typical treatment plans for idiopathic scoliosis can include:
• curves less than 25 to 30 degrees observed and monitored regularly
• bracing for curves 30 to 40 or 45 degrees (prefer to use on children who are still growing)
• consider bracing for curves that progress rapidly to 20 to 25 degrees
• consider surgery for curves larger than 40 to 50 degrees
• diagnostic MRI if curve is more than 20 degrees or atypical
• curves less than 20 degrees observed and monitored regularly
• bracing for curves 20 to 50 degrees
• bracing for smaller curves that progress rapidly to 20 to 25 degrees
• growing rods or vertebral stapling for very large curves or some curves not responsive to bracing
• brief observation to determine if curves are self-resolving
• MRI for diagnosis in persistent curves
• casting followed by bracing for persistent or larger curves
• surgery for very large curves (often dual growing rods)
In the unlikely event that your child needs surgery (spinal fusion) to correct her scoliosis curves, preparation for—and attention to—her care during the healing period will help ensure a positive outcome:
• For about three months after surgery—and to some extent throughout the healing period—she
must restrict certain physical activities, such as running, sports, lifting, bending and twisting. After
three months, she can gradually return to nearly all activities.
• Some at-home modifications in advance of her surgery will help her avoid activities and motions
that put her fusion at risk:
- Place often-used items within easy reach—no bending.
- Place groceries on shelves—no lifting heavy grocery bags.
- Modify your expectations of her chores—no bed-making or other bending/twisting activities.
- Consider putting her bed on the same floor as the bathroom.
• Follow your doctor's directions for physical therapy (stretching, strengthening and appropriate
As your child grows, your orthopedist will monitor her curve through frequent check-ups. Also, be sure to follow her regular program of well-child checkups. If your child is a teen, encourage her to live normally and to participate in sports and/or school activities. These will add greatly to her general health and sense of well-being.
Scoliosis is not a life-threatening condition, except in some early-onset scoliosis. The outlook for your child greatly depends on the nature and severity of her scoliosis and her age, since the amount of time remaining for her to achieve complete bone growth plays a big factor. Early diagnosis and early treatment can improve the outlook for many forms of scoliosis. Most children and adolescents diagnosed with scoliosis can look forward to normal, active lives.
At Boston Children's, we understand that a hospital visit can be difficult, and sometimes overwhelming. So, we offer many amenities to make your child's—and your own—hospital experience as pleasant as possible. Visit The Center for Families for all you need to know about:
• getting to Boston Children's
• navigating the hospital experience
• resources that are available for your family
In particular, we understand that you may have a lot of questions when your child is diagnosed with scoliosis. How will it affect my child long term? What do we do next? Boston Children's can help you connect with extensive resources to help you and your family through this stressful time, including:
We are grateful to have been ranked #1 on U.S. News & World Report's list of the best children's hospitals in the nation for the third year in a row, an honor we could not have achieved without the patients and families who inspire us to do our very best for them. Thanks to you, Boston Children's is a place where we can write the greatest children's stories ever told.”