U.S. News & World Report ranked Scottish Rite for Children, in collaboration with Children’s Medical Center Dallas and UT Southwestern Medical Center, as the No. 3 pediatric orthopedic program in the country in 2022. In 2013 – 2014, this same group was ranked No. 1 and has continued to place in the top five each year.
Check out the 2022 U.S. News & World Report Best Children’s Hospitals for Orthopedics rankings.
Spinal Fusion
The most common surgery performed to treat scoliosis is called a spinal fusion. In a spinal fusion, the curved vertebrae are fused together to create a single, solid bone. This stops the growth in the abnormal part of the spine and prevents the curve from worsening. Metal rods attached by screws are used to hold the spine in place until the bone heals. In all spinal fusions, a bone graft is used to help promote the fusion and the bones grow together to create one solid bone.
Vertebral Body Tethering (VBT)
VBT is a surgical treatment for idiopathic scoliosis in growing children. This surgery technique uses a strong, flexible cord that is attached to the spine with screws and anchors and as a child grows, their spine will straighten over time. The cord encourages the spine to straighten as the patient grows. Vertebral body tethering is a growth modulation treatment that takes advantage of the spine’s natural growth. Growth modulation means modifying the normal growth patterns through tethering. The tether is placed along the curved side of the spine. This tether is used to slow down the growth of the curved side of the spine while the untethered side continues to grow. By using a tether, the spine can continue to bend and flex. It is not a fusion procedure which is an advantage of pursuing this treatment.
MAGEC (MAGnetic Expansion Control) System ®
A MAGEC rod is a growing device technique used for patients diagnosed with early-onset scoliosis (EOS) – children under the age of 10. In comparison to a spinal fusion, this is a less invasive, innovative treatment that reduces the number of surgeries a child must undergo. Once the surgery has been performed and the MAGEC rod is in place, the back must heal for about four to six months. Once the spine has healed, then the patient will return to the clinic for his or her first lengthening session. During lengthening, the physician will use a magnetic wand to locate the magnets inside the MAGEC rod and make a mark on the back. Using an External Remote Control (ERC) device, the doctor will then lengthen the rod with a noninvasive adjustment. An X-ray or ultrasound of the spine is then used to confirm the procedure’s success.
Each surgical technique has different uses and not all types of surgery will be the right fit for every patient. It is important to discuss all treatment options with your doctor to learn what will work best for your child.
Learn more about scoliosis treatment and surgery at Scottish Rite for Children.
What is your job title/your role at Scottish Rite for Children?
As director of the Therapeutic Recreation department, I make sure my team has the resources and support they need to provide therapeutic recreation services to our patients. Therapeutic recreation services include inpatient interventions, outpatient interventions and community outreach programs, such as camps, All-Star Tennis and the Learn to Golf program. I also provide direct patient care when my teammates are occupied with other patients.
What do you do on a daily basis or what sort of duties do you have at work?
Each day is a little different, depending on variables like how many inpatients are in the unit, clinic schedules, project meetings and preparations for community outreach programs. On a typical day, I can find myself meeting with a patient and parent in the clinic, prepping for camps or pulling golf clubs and confirming instructors for Learn to Golf clinics.
What was your first job? What path did you take to get here or what led you to Scottish Rite? How long have you worked here?
My first job at Scottish Rite for Children was as the Therapeutic Recreation Coordinator. In 1997, Scottish Rite opened the Jas. F. Chambers Jr. Youth Fitness Park, and I had the privilege of using that park as a tool. At the time, we didn’t have a therapeutic recreation department. I’ve been blessed to be surrounded by wonderful colleagues while developing therapeutic recreation programs that provide a variety of services for our patients. Prior to coming to Scottish Rite, I provided therapeutic recreation services in mental health settings for about 10 years. This October, I celebrate 25 years at Scottish Rite.
What do you enjoy most about Scottish Rite?
“Our patients” is the easiest answer. But beyond the patients, I’ve developed some close friendships with other staff members that bring amazing joy to my life. People – they are important. At Scottish Rite, that message comes through.
Tell us something about your job that others might not already know.
Although I run a junior golf program for our patients and approximately 50% of my job is devoted to Learn to Golf, I’m lucky if I get to play golf three to four times a year! Most folks think I play golf all the time.
Where is the most interesting place you’ve been?
I find most places I go very interesting. It’s a toss-up between Addo Elephant Park in South Africa or sailing in the British Virgin Islands. However, I find that my own backyard is really interesting, too!
What is your favorite game or sport to watch and play?
I’m not much of a spectator. I love to play golf!
What’s one fun fact about yourself?
I’ll get to be a part of history because I am going to be at the inaugural U.S. Adaptive Open in Pinehurst on July 18 – 20, 2022. Because of the Learn to Golf program, I’ve become friends with several adaptive golfers who are in the Championship Field.
After a teammate and her mom described the gymnast’s wrist pain and treatment plan, Delaney and her mom took their advice to see someone at Scottish Rite for Children about her similar complaints. Pediatric sports medicine physician Jane S. Chung, M.D., confirmed that Delaney also had gymnast’s wrist, an overuse injury, in one hand and was showing signs of it developing on the other. The treatment plan started with immobilization, a cast on one arm and a removable splint on the other, and a new approach to training while protecting her wrists. Delaney was committed to this plan. At one point, Delaney even opted to extend her time in the cast just to be sure she didn’t go back too soon. “I wanted to be sure my wrist was ready, so I listened to Lindsey and kept working on my other goals like stretching for splits.”
“We were very concerned when we learned this could affect her growth. She had only complained of pain for a couple of weeks, we are glad that we received the advice to get it checked out.” Delaney’s mom recalls their initial surprise and hopes others will learn to watch out for signs of gymnast’s wrist.
Delaney, and sometimes her brother Luke, have enjoyed the activities that Lindsey has given her to increase the use and strength in her hand, wrist and arm. Delaney and her mom appreciate that Lindsey can talk-the-talk. Her mom says, “she knows gymnastics lingo, and she knows the demands of the sport.” Lindsey worked her magic with Delaney, getting to know her as an individual, looking for her motivations and challenging her to find ways to keep moving forward even when she was ordered to “rest.”
Lindsey says, “I’m excited to see Delaney ready to graduate from occupational therapy and return to her sport. I love my job and seeing kids getting to do what they love makes me love it even more.”
Learn about overuse injuries in gymnasts wrist.
What is Scoliosis?
Scoliosis is a progressive condition that causes the spine to curve into an “S” or “C” shape. It affects approximately two to three percent of school-aged children and is most common in girls ages 10-15. There are several different types of scoliosis, but the most common is adolescent idiopathic scoliosis (AIS).
Causes and Risk Factors
Idiopathic means that the cause is unknown. Research has proven that scoliosis has a genetic component and tends to run in families. Children with a family history of scoliosis are more at risk, especially those aged 10-15. Girls tend to be diagnosed with scoliosis more than boys, and the condition is not limited to a specific ethnicity or race. Groundbreaking research at Scottish Rite for Children is working to determine the cause of scoliosis, better understand factors that lead to curve progression, explore ways to prevent curve progression and improve treatments.
In congenital scoliosis, the cause is known. For example, a child may be born with a misshapen vertebra, one of the building blocks of the spine. Interestingly, recent research has also shown that congenital scoliosis may be partially genetic as well. Finally, a scoliosis curve may also develop from an underlying neurological disorder, known as neuromuscular scoliosis.
Dispelling the Myths
When it comes to scoliosis, it is important to know facts versus fiction. Below we correct some of the myths about scoliosis:
Early Treatment is the Key
Early screening and intervention are key to successful scoliosis treatment. It is important that your child is screened by a health professional for scoliosis annually so that any abnormalities can be identified quickly. Screening involves looking at the spine via physical examination for asymmetry of the shoulders, shoulder blades and hips. A parent, school nurse or friend may notice a small difference in the shape of your child’s back or you might notice that clothes begin to fit differently. Depending on where the curve is located in the spine, when you look in a mirror, you may see that one shoulder is raised or that “one hip is higher than the other.” In most schools, girls are screened in school at age 10 and again at age 12, while boys are screened once at age 13 or 14. If your child appears to have scoliosis during a screening, you will be notified and sometimes referred to an orthopedic specialist. If the specialist confirms true scoliosis, then the sooner treatment is begun, the need for surgery may be able to be avoided.
Bracing to Prevent Surgery
In less severe cases of scoliosis, surgery can altogether be avoided with the use of an orthotic brace. Braces are highly effective in treating scoliosis, but only if they are worn properly and according to the doctor’s guidelines. At Scottish Rite, all scoliosis braces are made on-site in our Orthotics & Prosthetics lab. This allows us to make same-day adjustments for fit or comfort. Wearing a brace diligently can prevent the progression of the curve, reducing the need or risk for surgery.
Each scoliosis brace that we make includes two dime-sized temperature sensors that track wear time. One is for our record keeping and can be tracked with each visit. The other is a Bluetooth sensor that can be connected to the parent and patient’s cell phone app. Created by Scottish Rite experts, the Brace Rite app uses real-time data, allowing parents, patients and your doctor to monitor wear time to ensure your child stays on track.
Physical Therapy to Prevent Progression
While scoliosis cannot be prevented, certain physical therapy techniques can be used to treat the condition and may prevent further progression. Scottish Rite has physical therapists that are trained and certified in the Schroth Method, a scoliosis-specific exercise approach. The Schroth Method focuses on correction of the curve pattern through a combination of stretching, strengthening and breathing in reverse directions, all based on each patient’s unique spinal curve. Using the Schroth Method can stop the progression of the curve, improve mobility and promote proper posture.
My Child Needs Surgery – Now What?
Not all cases of scoliosis can be treated without surgery. In significant curves of 45 to 50 degrees or more, surgery may be the best treatment option. There are several surgical techniques used to treat scoliosis, but the most common is spinal fusion. In a spinal fusion, the curved vertebrae are fused together to create a single, solid bone. This stops the growth in the abnormal part of the spine and prevents the curve from worsening. Metal rods attached by screws, hooks and/or wires are used to hold the spine in place until the bone heals. In all spinal fusions, a bone graft is used to help promote the fusion and the bones grow together to create one solid bone. Once a spinal fusion has been performed, patients can usually return to their normal activities within three to four months. However, each case is unique and some timelines may differ. At Scottish Rite, our Sarah M. and Charles E. Seay/Martha and Pat Beard Center for Excellence in Spine employs six pediatric orthopedic surgeons who specialize in spinal surgery for scoliosis using the latest innovative techniques and treatment methods.
Learn more about the importance of scoliosis screening.
