Avoiding scoliosis and maintaining good posture are universal concerns among parents today. During June, National Scoliosis Awareness Month, HSS doctors are stressing the importance of early detection of scoliosis in children.
Scoliosis is usually detected by a pediatrician or school nurse during school screening or parent (often times some asymmetry of the rib cage may be noted while a child is in a bathing suit or when trying on clothes). A child with scoliosis may have a protruding scapula or uneven hips, where one leg appears longer.
At HSS, in children younger than ten years of age, an MRI of the entire spine is recommended. MRI images can help the orthopedist detect the presence of other problems such as syrinx, a cyst in the spinal cord, or tethered cord, in which the spinal cord is abnormally attached to the bony spine.
Scoliosis is diagnosed as one of three types: idiopathic, of unknown origin; congenital scoliosis, in which the bones are asymmetrical at birth and the vertebrae may be partially formed (hemi-vertebra) or wedge-shaped; and neuromuscular scoliosis, in which the scoliosis is symptomatic of a systemic condition such as cerebral palsy, muscular dystrophy, or paralysis.
In all its forms, early diagnosis of scoliosis is a primary goal. Treatment is guided by the specific scoliosis type, the amount of growth the child has left, the degree of the deformity, and anticipated progression of the condition. Children with infantile and juvenile scoliosis have the greatest risk of curve progression, as well as the greatest risk of developing secondary pulmonary complications from scoliosis.
Dr. Roger Widmann is a pediatric orthopedic surgeon and the Chief of Pediatric Orthopedic Surgery at Hospital for Special Surgery. He practices at both the HSS Outpatient Center in Paramus and the hospital’s main campus in New York.