KidsMD Health Topics

Scoliosis

  • Patients come here from around the world for their scoliosis treatment. We're happy to be able to provide world-class care for them and for our local patients.

    --Spinal Program Team, Orthopedic Center

    If your child has been diagnosed with scoliosis, we know that you and your family are under stress. So, at Boston Children’s Hospital, we’ll approach your child’s treatment with sensitivity and support—for your child and your whole family.

    You can have peace of mind knowing that the team in the Boston Children’s Spinal Program has treated many children with spinal problems—some of which are so rare that few pediatric doctors have come across them—and we can offer you expert diagnosis, treatment and care. Scoliosis is not usually a life-threatening condition, and most children grow up to lead normal, active lives.

    About scoliosis

    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.

    Scoliosis occurs, and is treated, as three main types:

    • idiopathic scoliosis: the most common form, with no definite cause, mainly affecting adolescent girls, but existing in three age groups:
      • adolescent idiopathic scoliosis
      • juvenile idiopathic scoliosis
      • infantile (early-onset) idiopathic scoliosis
    • neuromuscular scoliosis: associated with a neuromuscular condition such as cerebral palsy, myopathy or spina bifida
    • congenital scoliosis: present at birth, caused by a failure of the vertebrae to form normally—the least common form

    We take a team approach to the treatment and care of idiopathic scoliosis:

    • A doctor, nurse, orthotist and physical therapist form the care team for most patients.
    • The team stresses non-surgical techniques whenever possible, with surgery a last resort. We use the safest and most efficacious techniques available.
      • We emphasize orthotic treatment for the effective control of idiopathic scoliosis.
    • Our team collaborates to tailor our program to the individual needs of each patient:
      • We adjust follow-up intervals and the x-ray needs to a child’s risk of a worsening curve.
    • When needed, we communicate with other disciplines, such as pulmonology (lungs) and neurology (nervous system).
    • We provide orthopedic care—including for scoliosis—at Boston Children’s satellite locations, as well as the main campus in Boston.
    • Infants and young children pose special problems with idiopathic scoliosis:
      • We can often treat babies and children with specially developed non-operative and surgical techniques.
      • Because we’re internationally known as a leading early-onset scoliosis center, our team is regularly consulted by other physicians and families around the globe.

    Scoliosis: Reviewed by M. Timothy Hresko, MD
    © Boston Children's Hospital, 2014


  • At Boston Children’s Hospital, our Spinal Program team develops innovative treatments for scoliosis and other spine conditions. And because our research informs our treatment, we’re known for our science-driven, experience-based approach.

    We’re home to the world’s most extensive pediatric hospital research enterprise, and we partner with elite health care and biotech organizations around the globe. But as specialists in innovative, family-centered care, our physicians never forget that your child is precious, and not just a patient.

    In dealing with your child’s scoliosis, you may want to know the basics about the spine and about the several forms of this spinal condition.

    What is the spine?


    Spine viewed from the front and side

    Made up of many individual bones called vertebrae, the spine is joined together by muscles and ligaments. Flat, soft discs separate and cushion each vertebra from the next. Because the vertebrae are separate, the spine is flexible and can bend. Together the vertebrae, discs, muscles and ligaments make up the spine or vertebral column.

    Different regions of the spine are named differently. The cervical spine refers to the neck, the thoracic spine to the chest, and the lumbar and sacral spines to the lower back.

    What are normal and abnormal front-to-back spine curves?

    The normal spine is strong and mobile. While it varies in size and shape from person to person, the healthy spine has natural front-to-back curves that enable us to walk, balance, sit, stand and twist—all of which are complex interactive movements. When these natural front-to-back curves become too large, they can present a potential problem.

    • When the backward curve in the thoracic spine is too great, the condition is called kyphosis (thoracic hyper-kyphosis, “round back”).
    • When there’s not enough backward curve in the thoracic spine, the condition is called hypo-kyphosis.
    • When the natural outward curve in the thoracic spine is actually reversed, curving into the chest, the condition is called thoracic lordosis.
    • When the inward curve in the lower back is too great, the condition is called hyper-lordosis (“swayback”).

    Are side-to-side-curves normal?

    No. Although the spine has natural curves from front to back, it shouldn’t curve sideways very much. A side-to-side curve is called scoliosis, and may take the shape of an “S” (double curve) or a long “C” (single curve).

    The scoliotic spine is also rotated or twisted to form a multi-dimensional curve. Spinal curvature from scoliosis may occur on the right or left side of the spine, or on both sides in different sections. Both the mid- (thoracic) and lower (lumbar) spine may be affected by scoliosis.

    What is scoliosis?

    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. In serious cases, lung function can be affected.

    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. Scoliosis does tend to run in families, although no one genetic link has been confirmed.

    What are the three main types of scoliosis?

    Scoliosis occurs, and is treated, as three main types:

    • idiopathic scoliosis: the most common form of scoliosis, most commonly seen in adolescent and pre-adolescent girls. “Idiopathic” simply means that there is no known cause. Nothing you or your child did caused it, and there’s nothing you could have done to prevent it.

      Fortunately, most cases require no intervention. Idiopathic scoliosis does tend to run in families, and girls are five to eight times more likely to develop it than boys. One exception is infantile idiopathic scoliosis, which occurs by the age of 3 years, and affects boys more than girls.

    Idiopathic scoliosis is sub-classified according to age at onset:

    • adolescent
      • the vast majority of cases
      • mostly occurring in girls ages 10 to 18 years
      • often not needing intervention
      • progression usually stops upon physical maturity
         
    • juvenile
      • about 10 percent of cases
      • occurring in children ages 3 to 9 years
      • usually progressive
         
    • infantile (early-onset)
      • up to 5 percent of cases; extremely rare
      • more often occurring in boys from birth to age 3 years
      • often self-resolving, but sometimes very serious
      • usually detected in first year of life

    What are the signs and symptoms of scoliosis?

    Because of the many possible combinations of curvatures, scoliosis can be very different in different people. Common signs and symptoms of scoliosis may include:

    • uneven shoulder heights
    • head not centered with the rest of the body
    • uneven hip heights or positions
    • uneven shoulder blade heights or positions
    • prominent shoulder blade
    • when standing straight, uneven arm lengths
    • when bending forward, the left and right sides of the back are asymmetrical

    Symptoms that suggest scoliosis can resemble those of other spinal conditions or deformities, or may result from an injury or infection.

       

    Who will be on my child’s scoliosis treatment team at Boston Children’s?

    Your child’s team at Boston Children’s can include her doctor, orthotist (a specialist who makes braces), physical therapist and nurse, who will guide you through the treatment process. If your child requires bracing, the team will help her make the sometimes difficult adjustments involved in wearing a brace.

    The physical therapist will evaluate your child’s posture, muscle strength and flexibility, and will design a home exercise program just for her.

    The nurse will help with all your questions and appointments. The nurse can:

    • teach your child how to care for herself and her brace
    • design a schedule for her to follow
    • help her plan her day-to-day activities
    • help her meet others who wear braces, in person and/or online

    FAQ

    Q: If my child has scoliosis, will she be OK?

    A:
     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.

    Boston Children's Hospital research into spinal problems, including scoliosis, directly informs how we care for your child. As a result, the majority of children treated for scoliosis at Children’s have had therapies that enable them to walk, play and live full lives.

    Q: How does Boston Children’s treat scoliosis?

    A:
     Treatment for spinal problems depends on the nature and severity of the condition. Whether your child’s particular spinal condition is congenital-, idiopathic- or neuromuscular-related, Boston Children’s Spinal Program provides comprehensive treatment—including evaluation, diagnosis, consultation and follow-up care. Treatments can include:

    • simple observation and monitoring
    • physical therapy
    • bracing
    • casting
    • surgery

    Q: If my child has—or is developing—scoliosis, what should I ask her doctor?

    A:
     Ask your Boston Children’s doctor:

    • What is happening to my child, and why?
    • Are other tests needed to diagnose my child?
    • What actions might you take after you reach a diagnosis?
    • What will happen with growth over time?
    • Will there be restrictions on my child’s activities?
    • Will there be long-term effects?
    • What can we do at home?

    Q: How is a spinal problem usually detected?

    A: Most spinal problems are detected by a child’s parents or pediatrician, or by school screenings.

    Q: How is scoliosis usually diagnosed?

    A: 
    Once a problem is detected, doctors will use a medical and family history, physical exams and diagnostic tests to determine the nature and extent of your child’s spinal condition and options for treatment. Testing can include:

    Q: Is scoliosis related to poor posture?

    A:
     No. Scoliosis is a spinal abnormality. It’s neither a cause nor a result of poor posture.

    Q: How common is scoliosis?

    A:
     According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, three to five out of every 1,000 children develop spinal curves that are considered large enough to require treatment. The condition is more common in girls than boys.

    Q: What is the long-term outlook for children with scoliosis?

    A:
     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.

    As your child grows, your orthopedist will monitor her curve through frequent check-ups. Be sure to also 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.

    Q: What causes abnormal spinal curves?

    A: 
    There are several causes of abnormal spinal curves:

    • In many cases, as in idiopathic scoliosis, there’s no definite cause for (or way to prevent) the spine’s failure to grow as straight as it should.
    • Some babies are born with spinal formation problems that cause the spine to grow unevenly—for example, congenital scoliosis, congenital kyphosisspina bifida or Klippel-Feil anomaly.
    • Some children have nerve or muscle (neuromuscular) diseases, injuries or other illnesses that cause spinal deformities—for example, cerebral palsyspina bifida or muscular dystrophy. In these conditions, muscle abnormalities combined with the child’s growth result in deformity.

    Other causes may include:

    • bone dysplasias: many generalized abnormalities of bone formation are associated with scoliosis
    • connective tissue disorders: conditions with abnormal tissues and ligaments, such as Marfan syndrome and Ehlers-Danlos syndrome
    • differences in leg lengths: mild leg length differences may cause a slight curvature but rarely cause a serious curvature
    • spinal cord injury with paralysis
    • infection
    • tumors

    Q: Does scoliosis hurt?

    A: 
    Actually, most scoliosis isn’t painful in adolescents and children. But there's still the potential for significant risk of pain developing in adulthood.

    Q: Will scoliosis affect my child’s lungs and/or other organs?

    A:
    The lungs may be affected by severe scoliosis, particularly early-onset scoliosis. But even a severe spinal deformity doesn’t usually affect the function of other organs.

    Q: Will my other children have spinal defects?

    A: 
    The possibility of a genetic component of spinal defects is still being studied. What’s known is that idiopathic scoliosis does tend to run in families. If you have a child with a spinal defect, it’s advisable to consult a geneticist, who can take a family history and discuss your particular situation.

    Q: When should I seek medical advice for my child?

    A: Scoliosis will usually become apparent as your child grows. Consult your pediatrician if her:

    • shoulders are of uneven heights
    • head isn’t centered with the rest of her body
    • hips are of uneven heights or positions
    • shoulder blades are of uneven heights or positions
    • arms hang beside her body unevenly when she stands straight
    • left and right sides of her back appear different in height when she bends forward

    Q: What questions should I ask the physician?

    A: If your child is diagnosed with scoliosis, you may feel overwhelmed with information. It can be easy to lose track of your questions. Many parents find it helpful to jot down questions as they arise.

    Some of the questions you may want to ask include:

    • What is happening to my child, and why?
    • Are other tests needed to diagnose my child?
    • What actions might you take after you reach a diagnosis?
    • What will happen with growth over time?
    • Will there be restrictions on my child’s activities?
    • Will there be long-term effects?
    • What can we do at home?

    Q: Who’s at risk for scoliosis?

    A: Risk factors for developing the most common form of scoliosis (idiopathic) include:

    • age—With the onset of puberty, during the maximum growth spurt, signs and symptoms of scoliosis may begin to manifest themselves.
    • gender—Girls are five to eight times more likely than boys to develop scoliosis.
    • heredity—Idiopathic scoliosis tends to run in families.

    Click here to view the Scoliosis Glossary.

  • The first step in treating your child is forming an accurate and complete diagnosis.

    Scoliosis can be difficult to diagnose. Sometimes the curves are obvious, but in other cases, they aren’t immediately visible. Curves often aren’t painful and usually progress slowly, so they can be overlooked until a child approaches puberty. Detecting scoliosis early is most important for successful treatment.

    Pediatricians, family physicians and some school programs routinely look for signs that scoliosis may be present. Once a problem is detected, doctors will use a medical and family history, physical exams and diagnostic tests to determine the nature and extent of your child’s scoliosis.

    Your doctor will review your child’s complete prenatal and birth history, as well as any family history of scoliosis. We will review your child’s developmental milestones, since some types of scoliosis can be associated with other neuromuscular disorders.

    During your child’s physical exams, her physician will look for and measure abnormal contours that indicate scoliosis. Through physical exams and diagnostic testing, the doctor will determine the:

    • shape of the curve (“S”- or “C”-shape; involvement of ribs and muscles)
    • location of the curve (upper [thoracic] spine; lower [lumbar] spine; or both [thoracolumbar])
    • direction of the curve (bend to left or right)
    • angle of the curve in degrees (Cobb angle)

    X-rays and other tests

  • How we'll treat your child's scoliosis depends on the complexity and severity of her condition. Whether her scoliosis is idiopathic-, neuromuscular- or congenital-related, the Boston Children's Hospital's Spinal Program provides comprehensive treatment—including evaluation, diagnosis, consultation and follow-up care.

    Treatments can include:

    • observation and monitoring: 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 physician will determine your treatment plan and follow-up based on your child's x-rays and physical exams.
    • physical therapy: Physical therapy often can help scoliosis. The goal of our physical therapy team is to maximize your child's physical functioning. Our therapists work closely with the Spinal Program to provide exercise programs and additional therapies to address any pain and the muscular imbalance that can be associated with spinal abnormalities.
    • bracing: 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 specifically designed for your child's particular curve. The brace holds your child's spine in a straighter position while she's growing to partly correct the curve or prevent it from increasing. A bracing program may help her avoid surgery.
    Bracing for Scoliosis at Boston Children's Hospital

    Bracing can help the spine grow straighter and prevent worsening of the curve.

    • casting: In certain situations—as in some cases of early-onset (infantile) scoliosis—body casting is indicated.
    • 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 combines fusion and instrumentation (rods and screws) to correct and solidify the curve.
      • thoracoscopic anterior spinal surgery and instrumentation: a minimally invasive approach to spine fusion
      • hemivertebra and wedge resections (for congenital scoliosis): removal of the abnormal spine segment and reconstruction of the spine
      • spinal osteotomy: controlled breaking or cutting and realigning of bone into a corrected 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
    • for younger, growing children:
      • dual posterior growing rods (for early-onset scoliosis): control spinal deformity while allowing spinal growth with periodic lengthening
      • 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

    Click here to see our Embrace the Brace Digital Slideshow.
    Patients and providers offer advice to help others with scoliosis thrive while wearing a brace.

    Complications

    Complications from adolescent idiopathic scoliosis after treatment are uncommon, the most common being back pain and residual curvature. However, if left untreated, adults with moderate or severe scoliosis can have progressively worsening curves that cause cosmetic disfigurement, back pain and, in rare cases, difficulty breathing.

    Treatment in adulthood after the curve has already become severe may be somewhat less successful than treatment during childhood or adolescence. By treating your child’s progressive curve early, we hope to keep it from becoming a problem in adulthood.

    Coping and support

    A hospital visit can be challenging and sometimes overwhelming. Boston Children’s offers amenities to make your child's—and your own—hospital experience as pleasant as possible. Visit The Center for Families for information about:

    • getting to Boston Children's
    • accommodations
    • navigating the hospital experience
    • resources available for your family

    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? We can help you connect with extensive resources to help you and your family, including:

    • patient education: From doctor's appointments to physical therapy and recovery, our nurses and physical therapists will be on hand to walk you through your child's treatment and help answer any questions you may have: Will my child need surgery? How long will her recovery take? How should we manage home exercises and therapy? We'll help you coordinate and continue the care and support you received while at Boston Children's.
    • parent-to-parent: Do you want to talk with someone whose child has been treated for your child's form of scoliosis? We often can put you in touch with other families who've been through the same process or procedure that you and your child are facing, and who will share their experiences. To learn more about Family to Family services, please email FamilytoFamily@childrens.harvard.edu.
    • faith-based support: If you're in need of spiritual support, we'll connect you with the Boston Children's chaplaincy. Our program includes nearly a dozen clergy—representing Protestant, Jewish, Muslim, Catholic and other faith traditions—who will listen to you, pray with you and help you observe your own faith practices during your hospital experience.
    • social work: Our social workers and mental health clinicians have helped many other families in your situation. We can offer counseling and assistance with issues such as coping with your child's diagnosis, stresses relating to coping with illness and dealing with financial issues.
    • Curvy Girls is a network of peer-to-peer support groups for teens with scoliosis. Click here to find a group in your area.

    For teens

    Besides the typical issues any teenager faces—from social acceptance to body changes and more—if you’re undergoing bracing and physical therapy for scoliosis, it’s true that you’ll also have to deal with medical appointments, feeling different and assuming a big personal responsibility for maintaining your own good health. If your scoliosis is mild or moderate, you may wonder why we need to monitor and treat it, since it may not be painful or bothersome.

    It’s important for you to know that if left untreated until you’re an adult, your moderate or severe scoliosis can worsen, resulting in curves that cause cosmetic disfigurement, back pain and, in severe cases, difficulty breathing.

    Treatment in adulthood after the curve has already become severe may be somewhat less successful than treatment during adolescence. By treating your progressive curves early, we hope to keep them from becoming problems when you reach adulthood.

    It also may help you to know that you can participate in sports and other normal activities; your general health will improve with an active lifestyle. If you’ll be wearing a brace, most braces can be worn, unseen, underneath your clothes. And they can be removed for sports.

    • If you feel overwhelmed, depressed or anxious through this important time in your transition to adulthood, speak to your doctor or counselor to get help. And check out Curvy Girls for teens with scoliosis. Click here to find a group in your area.

    For adults

    What you can do at home

    As your child grows, your orthopedist will monitor her curve through frequent checkups. Be sure to also 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.

  • A long line of orthopedic firsts

    With a long history of excellence and innovation and a team of clinicians and researchers at the forefront of orthopedic research and care, Boston Children's is home to many treatment breakthroughs:

    • one of the first scoliosis clinics in the nation
    • advances in our Spinal Program, such as video-assisted thoracoscopic surgery
    • the oldest and largest comprehensive center for the care of spina bifida
    • a hip program that has performed more than 1,200 periacetabular osteotomies
    • one of the first sports medicine clinics in the nation
    • advanced techniques and microsurgery care for complex fractures and soft tissue injuries to the hand and upper extremity
    • one of the first centers in the nation to use adjuvant chemotherapy and perform limb salvage surgery for patients with osteosarcoma

    Clinical Effectiveness Research Center

    The Orthopedic Clinical Effectiveness Research Center (CERC) helps coordinate research and clinical trials to improve the quality of life for children with musculoskeletal disorders. This collaborative clinical research program is unique in the nation and plays an instrumental role in establishing—for the first time—evidence-based standards of care for pediatric orthopedic patients throughout the world.

    Major areas of focus for the CERC include:

    • spinal disorders
    • hip disorders
    • upper extremity disorders
    • brachial plexus birth palsy
    • trauma/fractures

    Physicians in the Spinal Program are pursuing several areas of basic and clinical research based at Boston Children’s and the Harvard Orthopaedics Biomechanics Laboratory. Research topics include:

    • idiopathic scoliosis and congenital scoliosis
    • spondylolisthesis and spondylolysis
    • bone density studies of braced patients
    • in vitro mechanical testing of lumbosacral fixation devices
    • computer-assisted strength analysis of vertebral metastases
    • blood loss conservation during spinal surgery
    • pain management during spinal surgery

    Clinical trials

    For more than a century, orthopedic surgeons and investigators at Boston Children’s have played a vital role in the field of musculoskeletal research, pioneering treatment approaches and major advances in the care and treatment of ailments such as scoliosis, polio, tuberculosis, hip dysplasias and traumas to the hand and upper extremities.

    Our pioneering research helps answer the most pressing questions in pediatric orthopedics today—providing children with the most innovative care available.

    At Boston Children’s Orthopedic Center, we take great pride in our basic science and clinical research leaders, who are recognized throughout the world for their respective achievements. Our orthopedic research team includes:

    • five full-time basic scientists
    • 28 clinical investigators
    • a team of research coordinators and statisticians

    Ongoing studies

    Ongoing clinical studies include:

    Spine Studies Partially Sponsored by the Spinal Deformity Study Group (SDSG): The mission and purpose of the SDSG is to create a means and forum whereby multi-center studies can be developed and conducted both efficiently and effectively. The SDSG is comprised of 50 national and international spine surgeons from 35 participating sites worldwide. John Emans, MD, director, Division of Spinal Surgery, and M. Timothy Hresko, MD, orthopedic surgeon, are members of the SDSG.

    • (SDSG) Prospective Pediatric and Adolescent Scoliosis Study: This is a multi-center study focused on the outcomes of pediatric and adolescent idiopathic scoliosis. The main purpose of this observational study is to develop a prospective comprehensive radiographic and clinical database on consecutively treated pediatric and adolescent scoliosis surgical cases to assess outcome measures in patients with operative idiopathic scoliosis being treated with current surgical techniques. A secondary objective is to obtain data on currently available surgical approaches to treat idiopathic scoliosis in the thoracic, thoracolumbar and lumbar spine.
    • (SDSG) Prospective Pediatric and Adolescent Kyphosis Study: The main objective of this prospective multi-center, observational study is to assess outcome measures in pediatric and adolescent patients with kyphosis who are being treated non-operatively or operatively with current surgical techniques. A secondary objective is to collect data on currently available surgical approaches to treat pediatric kyphosis in the thoracic and/or thoracolumbar spine.
    • (SDSG) Prospective Study of Deformity Management and Pulmonary Function in Early-Onset Scoliosis: The goal of this prospective multi-center study of children with idiopathic scoliosis is to document concomitantly: 1) control of spinal deformity; 2) growth of the thoracic spine longitudinally and transversely at a rate commensurate with the number of vertebrae involved; and 3) increasing lung volume, absolute and relative to body size.
    • (SDSG) The Effect of Surgery on Sagittal Spino-pelvic Measures of Balance in Developmental Spondylolisthesis and Its Relation to Clinical Outcome: The short-term goal of this prospective multi-center, observational study is to confirm the predictive value of sagittal spino-pelvic measurements in the surgical treatment of L5-S1 developmental spondylolisthesis. The long-term objective is to determine the optimal surgical treatment for L5-S1 developmental spondylolisthesis based on x-ray evaluation of sagittal trunk balance and functional outcome.

    Other Multicenter Studies of Importance: By combining efforts with other centers, the Division of Spine Surgery at Boston Children’s is able to more quickly reach valid research conclusions applicable to clinical practice.

    • Bracing in Adolescent Idiopathic Scoliosis Trial (BrAIST) is a multi-center, randomized trial funded by the National Institutes of Health. Boston Children’s was one of 18 pediatric centers in North America to participate in this clinical trial. Results in the New England Journal of Medicine, published on Sept. 19, 2013, provided strong evidence for the value of bracing patients with adolescent idiopathic scoliosis.
    • Dual Growing Rod Instrumentation with Limited Fusion for the Treatment of Early Onset Scoliosis: This multi-center project is sponsored by the Growing Spine Study Group (GSSG). Initially a retrospective study, it has become a prospective, observational study with 14 clinical centers from around the world contributing data. The main goal is to determine how successful dual growing rods and Vertical Expandable Prosthetic Titanium Rib (VEPTR™) devices are in correcting progressive scoliosis in very young children. Secondarily, researchers want to know if children who undergo successful surgical intervention with these devices, to control their curve during growth, need to go on to receive a definitive final fusion. Or, if the hardware can be removed and the curve simply observed over time for possible progression. Recently, the study was modified to include a non-operative cohort of patients who are treated for early onset scoliosis with non-surgical methods, such as bracing and casting. Outcomes associated with operative and non-operative treatment will be compared in hopes that the most effective methods of correction can be identified.
    • Skeletal Complications in Neurofibromatosis Type 1 (NF1): This study is being conducted by researchers at Boston Children's and Beth Israel Deaconess Medical Center. The goal is to identify cell types associated with and responsible for skeletal defects and impaired bone healing associated with NF1. A large proportion of patients with NF1 display skeletal abnormalities, such as alterations in bone size and shape, the presence of scoliosis and a tendency to develop pseudoarthrosis. Tissue samples from patients with and without NF1 will be analyzed by microscopic examination. We hope the results will lead to a better understanding of the cells predominantly responsible for skeletal defects in NF1 and lead to new strategies for treating this patient population.

    Ongoing laboratory studies include:

    • Basic science studies
    • Biomechanical/instrumentation studies

    Children speak: What's it like to be a medical research subject?

    View a video of a day in the life of Children’s Clinical and Translational Study Unit, through the eyes of children who are “giving back” to science. 

  • Patient Stories

    Scoliosis surgery: from tears to smiles
    When Taylor Gomes found out she needed surgery to treat her #scoliosisshe was understandably scared. But keeping close communication with her Boston Children's doctor, Michael Glotzbecker, made things far less overwhelming.

    Straight talk on scoliosis: How I came to embrace the brace
    Chloe says her scoliosis can be hard to deal with at times, but ultimately makes her a stronger person. Since beginning treatment with Boston Children's Timothy Hresko, Chloe has organized a support group for teens with #scoliosis and stays active by skiing and running! Read her inspiring blog where she describes how she's turning struggle into positivity and learning to #EmbraceTheBrace

    Rachel Rabkin Peachman: Hope for an S-Shaped Back
    Schroth physical therapy, a technique Boston Children’s Hospital orthopedists use with some bracing patients, could help slow curve progression and reduce pain.

    Visceria Givans: Living with scoliosis
    Visceria Givans is a student athlete, diagnosed with scoliosis in grade school. She received corrective spine surgery at Boston Children's Hospital and a few years later and is actively playing sports again.

    Anjellina Guiliano: Around the bend
    For  most children with scoliosis, the path to recovery is marked by simple observation and bracing. But when one patient battles two curves, her path - and spine - take an unexpected turn. 

    Zoe Lambert: Titanium rib procedure gives patients room to breathe
    Born with a rare birth defect, Zoe is one of the first patients to receive a VEPTRTM device at Boston Children’s.

    Marston Mills boy prepares for innovative scoliosis surgery
    Nathan Winslow underwent vertebral growth modulation (vertebral stapling) to treat his scoliosis.

    Bangor High softball players persevere, return to team after off-season surgeries 
    Boston Children’s patient and softball pitching ace Alexis Stanhope discusses her return to the field after scoliosis surgery.

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The future of pediatrics will be forged by thinking differently, breaking paradigms and joining together in a shared vision of tackling the toughest challenges before us.”
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