Excellence & Expertise in Spine Care: Putting Scoliosis in Its Place

Excellence & Expertise in Spine Care: Putting Scoliosis in Its Place

Previously published in Rite Up, 2025 – Issue 2.

By Kristi Shewmaker

Meet Hanna, a 12-year-old of Flower Mound, Texas, who loves listening to music while drawing; Bella, a 13-year-old all-around athlete of Lewisville, Texas, who enjoys soccer; and Coleman, a 17-year-old of Navasota, Texas, who is a three-time junior world champion rodeo calf roper.

These amazing kids do not know each other, but they share something in common. They all have scoliosis — adolescent idiopathic scoliosis (AIS) to be exact. However, each of them has received different treatments tailored to their specific, individual needs. What is more interesting than their condition is the way they are handling it — with resilience! With no known cause, AIS is the most common type of scoliosis in children and teens. It develops between the ages of 10 and 18, is found in as many as 4 in 100 adolescents and is more prevalent in girls. It is a progressive condition affecting the spine in which the scoliosis curve typically worsens during a child’s rapid growth period. The diagnosis can surprise parents as their child may have passed one or more scoliosis screenings.

Scoliosis is defined as a curve that measures more than 10 degrees on an X-ray. A straight spine is zero degrees. Children with curves less than 20 degrees are monitored. For curves between 20 and 45 degrees, bracing is recommended. For those above 45 to 50 degrees, surgery is recommended, which may include various types, such as a spinal fusion or vertebral body tethering (VBT). Spinal fusion is a procedure in which the vertebrae in the spine are fused together, creating a single, solid bone that is immediately straightened. Metal rods attached by screws are used to hold the spine in place until the bone heals. In a VBT procedure, a surgeon attaches a flexible cord to the spine, which slows the growth on one side of the curve while allowing growth on the other side, to straighten the spine over time. Hanna’s curve measures 23 degrees. She wears a brace 20 hours a day with the goal of halting the progression so that when she stops growing, she will not need surgery. Bella has two curves. Her thoracic curve, or upper spine curve, measured 61 degrees, and her lumbar curve, or lower spine curve, measured 52 degrees. Working with a pediatric orthopedic surgeon, she opted for a hybrid surgery that included a spinal implantation and fusion at the top and VBT at the bottom.

Coleman underwent a spinal fusion for two thoracic curves, with the largest measuring 83 degrees going into surgery. “An important message for patient families to know is that their children are going to live long, healthy, happy lives with this condition,” says pediatric orthopedic surgeon and Assistant Chief of Staff Brandon A. Ramo, M.D. “Whether they need a brace or surgery, that shouldn’t stop them from achieving their goals.”

Hanna

In sixth grade, Hanna was referred to Scottish Rite for Children by her family chiropractor who noticed the curve in her back. This news came after she passed her first scoliosis screening at school in fifth grade. At Scottish Rite, she was diagnosed with AIS.

“I was devastated,” says Taylor, Hanna’s father, “not only for Hanna having to go through this, but I also felt colossal amounts of guilt for not catching it.” Kelly, Hanna’s mother, explains that she was thankful they caught it when they did and not a year later when children get tested at school again in seventh grade. “We would’ve lost a year, and who knows how bad her curve would’ve been by then,” Kelly says. “We might’ve been having a very different conversation — one about surgery instead of a brace.”

Hanna chose a brace with a tattoo design that was custom made in-house by orthotist Christina Gambrell. “If I’m going to wear something for this long, then I’m going to make sure it looks cool,” Hanna says. She wears the brace night and day, taking only a four-hour break before bedtime. Because Scottish Rite’s Orthotics and Prosthetics team is onsite, they can measure, cast, mold, fit, align and fabricate braces without having to place an order with an outside company. At her appointments, Hanna receives adjustments to her brace as she grows to ensure that she is comfortable.

“Bracing is the one treatment we have that is proven with multiple studies to prevent surgery,” says Amy L. McIntosh, M.D., pediatric orthopedic surgeon. “Hanna is the perfect candidate for a brace. She’s going through peak height velocity, so it’s a great time to wear a brace to prevent progression of her curve.”

Based on her growth projection, Hanna has about a year to a year-and-a-half left of wearing her brace. In the meantime, Hanna is handling her treatment with grace. For kids with scoliosis who must wear a brace, she gives this advice: “Don’t make yourself think that you are weird for wearing it. It just proves that you have the strength to overcome it.”

Regarding the care that Hanna has received at Scottish Rite, Taylor says, “There’s not enough praise or kind words that we could dream up to describe it. On a scale of 1 to 10, it’s a 200! In terms of children’s health care, I couldn’t imagine anything better.”

Bella

Bella plays sports year-round, but soccer is her favorite. “It’s really fun, it relieves all my anxiety, and it makes me feel happy,” she says.

The first indication that Bella had scoliosis came in the form of a letter from her fifth grade school nurse. Then, her family noticed the difference in her shoulders — one was sticking out and the other seemed to be inverted. Brittanie, Bella’s mother, took her to their pediatrician who referred them to Scottish Rite.

Initially, Bella saw Dr. Ramo, who diagnosed her with AIS. “He showed us the degrees of her curves, and we were in total shock,” Brittanie says. Bella was scared. “I didn’t know if I could play soccer again,” she says. With a 61-degree thoracic curve and a 52-degree lumbar curve, Bella would need surgery. Dr. Ramo explained that she had options, including spinal fusion, VBT or a hybrid procedure that uses both. He suggested that she see pediatric orthopedic surgeon Jaysson T. Brooks, M.D., who performs the VBT procedure to discuss the possibilities.

Scottish Rite for Children has six pediatric spine surgeons who are leaders in their specialties and are laser-focused on providing the best evidence- based care. From the straightforward to the most complex spinal deformities, Scottish Rite surgeons practice team medicine, in which every child’s surgical plan is reviewed by not only their doctor but all six spine surgeons.

Dr. Brooks presented the options, and after having a long discussion with the family, they decided to proceed with the hybrid surgery that would fuse Bella’s upper spine and tether her lower spine. “Because most of your flexibility comes from your lower back, we try to avoid that area when it comes to fusing,” Dr. Brooks says. “If the lumbar curve is small enough, we leave it alone, but with Bella, the numbers weren’t adding up, so tethering was the best option for her to maintain her flexibility.” He emphasizes that every spine surgery is a shared decision- making process that depends on the patient’s individual needs and the family’s personal values.

After surgery, Bella stayed home from school for a month to heal. After three months, she began easing back into sports, and after six months, she was fully back. Reviewing her X-ray from her one-year follow-up, Dr. Brooks says, “Bella is rock-solid straight. She’s had about as great of an outcome as you can ask for.”

Brittanie describes Bella’s care as outstanding. “The whole team is so confident in what they do that it takes away your fear as a parent,” she says. For kids facing surgery for scoliosis, Bella’s advice is to trust in the process.

“There is no technique related to scoliosis that we can’t offer at Scottish Rite,” Dr. Brooks says. “Our nurses and surgical staff — all they do is pediatric orthopedics. With a highly specialized team that focuses on one thing, you’re bound to get better outcomes.”

Coleman

Coleman roped his first calf off a horse when he was 4 years old. For years, he has competed in the rodeo tie-down event. “You nod your head, they release the calf, you swing your rope, rope ‘em, jump off the horse, run down there, flank ‘em, and then you tie three out of the four legs,” he says.

With four or five horses saddled in an arena at his house, Coleman practices three to four hours a day. He earned junior world champion titles in 2017, 2018 and 2023. Just before his 2023 win, he was referred to Scottish Rite by an orthopedic surgeon who treats rodeo athletes. Coleman’s scoliosis was already past the surgical threshold when Dr. Ramo diagnosed him with AIS. “His curves were pretty big,” Dr. Ramo says. “He had a double thoracic curve pattern, which is uniquely difficult and one of the stiffest curve patterns that we treat.”

In order to flank and tie a calf, it is imperative to be agile and flexible enough to bend over easily. “I was afraid I wouldn’t be able to rope again,” Coleman says.

Dr. Ramo stresses the importance of individualized care for each patient. “We plan a treatment strategy that matches their needs — not just the needs for their back but also the needs for what they’re doing in their lives,” he says. Coleman wanted to finish the rodeo season before having surgery. “We planned his spinal fusion to fit his timeline and ensured that we maintained every bit of motion we could offer him with his active lifestyle and competitive spirit,” Dr. Ramo says.

At age 16, Coleman scored his best time at 7.4 seconds, a remarkable feat. But, the time to beat is 6.3 — the world record set by none other than his father, Ricky, who is in the Texas Rodeo Cowboy Hall of Fame and a 15-time National Finals Rodeo qualifier. Despite having major spinal surgery on a double thoracic curve, Coleman is on his way. He recently received a full scholarship to Southwest Texas College in Uvalde where he will compete on their rodeo team. Ultimately, he hopes to compete professionally in about 100 rodeos a year with the goal of making the National Finals Rodeo, often called “the Super Bowl of rodeo,” which features the top 15 in the world.

“There are misperceptions about people with scoliosis, that they can’t do sports or participate in certain activities,” Dr. Ramo says. “Coleman is a prime example of how that is absolutely not true — that you can live a very healthy, active life with this condition and be a world champion at what you do.”

Get to Know Our Staff: Tiffany Thompson, Clinical Research

Get to Know Our Staff: Tiffany Thompson, Clinical Research

What is your job title/your role at Scottish Rite?
I am a research coordinator for the spine team. I assist the spine doctors, fellows, residents and students with their research.

What is the most fulfilling part of your job?
I know that what I am doing is making a difference in the lives of the families we care for today and in the future.

What makes Scottish Rite a special place to you?
The atmosphere! I never had a job where you feel how much management truly cares for their employees. They go out of their way to make sure everyone feels included and appreciated.

What made you choose a career in health care?
I always had a special place in my heart for children, and I always pictured myself in a role that helps people. Previously, I worked in wildlife and environmental science. When the opportunity to make a career change arose, I was ready for it!

What is something unique you get to do in your position?
I get to interact with patients and their families. This may not sound unique, but I was not expecting this coming into my role.

What’s your favorite thing to do outside of work?
Spending time with my friends and family.

Where are you from and what brought you to DFW?
I am originally from Dallas and have stayed here because I want to stay close to my family.

If you could travel to anywhere in the world, where would you go and why?
Poland. My family is from there, and I have always wanted to see where we came from.

If you had to pick one meal to eat for the rest of your life, what would it be?
My husband’s barbecue chicken.

What movie do you think everyone should watch at least once?
“Sweet Home Alabama”

What was the first concert you attended?
I went to a Fourth of July bash and saw Vanilla Ice.

If you were to have a movie based on your life, which actress/actor would you choose to play your character?
Alexandra Daddario

What is some advice you would give your younger self OR what’s the best piece of advice you’ve received?
Do not settle on one career path. You should have an open mind and accept any opportunity that comes your way. You never know when the best one will come about.

Get to Know Our Staff: Alex Loewen, Movement Science Lab

Get to Know Our Staff: Alex Loewen, Movement Science Lab

What is your job title/your role at Scottish Rite?
I am a bioengineer in the Movement Science Lab at Scottish Rite for Children Orthopedics and Sports Medicine Center in Frisco. We use high-speed motion capture technology, similar to what is used in movies and video games, to record young athletes’ movements. As a bioengineer, I am responsible for ensuring the accuracy of data collected through our motion capture equipment. A significant part of my role involves developing the code that supports our analysis of the 3D motion capture data in a programming language called MATLAB.

What is the most fulfilling part of your job?
There are two main aspects of my job that I find fulfilling. First, we test athletes in our lab and generate reports, which identifies movement patterns that may increase their injury risk while playing their sports. As a former athlete myself, I understand how important it is to be able to continue playing the sport you love. Second, I develop ways to streamline our data processing methods, which ultimately supports every member of our incredible Movement Science Lab team.

What makes Scottish Rite a special place to you?
The culture at Scottish Rite is what truly makes it special. By keeping our focus on the patients we treat, we are constantly reminded of why we do what we do, which fosters a strong sense of purpose and dedication throughout the team.

What made you choose a career in health care?
I have always loved sports, so I initially planned to become a sports physical therapist. However, I ended up pursuing a master’s in biomechanics, which led me to the world of motion capture. There are many different avenues you can take in motion capture, but I chose health care. It allows me to have the most immediate impact on individuals.

What is something unique you get to do in your position?
One unique aspect of my position is how it molds engineering and health care in pediatric sports medicine. I get to apply advanced technology and data analysis techniques to understand and optimize movement patterns in young athletes.

What’s your favorite thing to do outside of work?
My favorite thing to do is spend time with my wife and 2-year-old daughter at the playground or the pool.

Do you have any hidden talents?
I play both the piano and ukulele.

Where are you from, and what brought you to DFW?
I’m originally from McKinney, Texas, and have spent my entire academic and professional career in the DFW area.

If you could travel to anywhere in the world, where would you go and why?
Within the U.S., my wife and I have a goal to visit every national park, so whichever one is next on our list is where I’d love to go. Internationally, I would choose Italy — partly for the scenery, but mostly because one of my love languages is pasta.

If you had to pick one meal to eat for the rest of your life, what would it be?
I would pick my abuelita’s huevos con salsita. It is a simple meal with flour tortillas, eggs, tomatoes and onions. No one makes it quite like her.

What was the first concert you attended?
I saw Luke Combs with Lainey Wilson and Cody Johnson.

Favorite hidden DFW gem?
Cris and John. If you have never tried a ramenritto or phodilla in your life, then you are missing out!

If you were to have a movie based on your life, which actress/actor would you choose to play your character?
John Krasinski

What is some advice you would give your younger self, OR what’s the best piece of advice you’ve received?
Something I would tell my younger self is to trust that God will open and close the right doors. It’s easy to get caught up in trying to control every outcome, but looking back, the best opportunities came when I allowed God to guide me.

How Olivia Faces Scoliosis With Resilience Through Bracing

How Olivia Faces Scoliosis With Resilience Through Bracing

Whether she is spiking a volleyball over the net or racing others in cross country, 17-year-old Olivia enjoys an active lifestyle with intensity, grit and heart. “Both sports have taught me about discipline, teamwork and pushing through challenges,” Olivia says, describing her involvement as a multisport athlete at school. She matches the strength she has shown on the court and trail to her care journey through scoliosis.

In fifth grade, Olivia’s school nurse noticed asymmetry in her spine during a routine scoliosis screening. Olivia’s spine curved in an ‘S’ shape, and her pediatrician confirmed the curve with an X-ray. To start receiving expert spinal care, Olivia and her family were referred to Scottish Rite for Children. Physician assistant Jessica Landson, P.A.-C., evaluated Olivia and diagnosed her with adolescent idiopathic scoliosis (AIS). AIS is the most common type of scoliosis and is more prevalent in girls than boys.

“When I was diagnosed, I was scared and overwhelmed,” Olivia says. “However, my Scottish Rite team did not just treat my condition but took the time to explain everything and made sure I was comfortable every step of the way.”

Landson also confirmed Olivia had two spinal curves — a 24-degree thoracolumbar curve, which is where the upper and lower spine meet, and a 20-degree thoracic, or upper, spine curve. Under Landson’s recommendation, Olivia wore a scoliosis brace to prevent her curves from progressing. Scottish Rite’s Orthotics & Prosthetics department measures every child to ensure each brace is customized to fit their needs. For children who wear braces, it can be difficult to adjust to their new treatment plan.

“I really disliked having to wear a brace,” Olivia says. “Yet deep down, I knew this would set me up with a better spine in the future. Because of my care team and the brace, I was able to keep doing the sports I love.”

As Olivia prepares to begin college at Texas Tech University, she looks ahead to a brace-free, active lifestyle filled with possibility. She describes her Scottish Rite experience as a 10 out of 10. “The people at Scottish Rite are amazing,” Olivia says. “They truly want to help you and will do everything they can to make your situation better. It’s the place that gave me the confidence and strength to move forward without fear.”

Do you have a story? We want to hear it! Share your story with us.

Grace in Motion: How Kathlynn Found Her Inner Strength With Scoliosis

Grace in Motion: How Kathlynn Found Her Inner Strength With Scoliosis

For Kathlynn, of Waxahachie, Texas, dance is not just a hobby. It is an outlet for expression that brings joy. Just days after Kathlynn’s 10th birthday, she and her family went to the pediatrician for a routine visit. The pediatrician noticed a curve in Kathlynn’s back and administered an X-ray, confirming two curves in her spine. After visiting another facility, the family began searching for resources in their area.

“My husband insisted on getting a second opinion from Scottish Rite for Children,” says Stacy, Kathlynn’s mother. “It was not because he did not believe in the diagnosis. You couldn’t deny the X-ray. However, my husband felt there had to be a place that catered to the experience of children.”

Kathlynn was evaluated by pediatric orthopedic surgeon Amy L. McIntosh, M.D., who diagnosed her with the most common type of scoliosis — adolescent idiopathic scoliosis. Specifically, Kathlynn has two spinal curves — a thoracic, or upper spine, curve of 21 degrees and a lumbar, or lower spine, curve of 22 degrees. During the same appointment, Kathlynn met with orthotist Sara L. Martinson, C.P.O., who custom made a brace to address her spine curve.

“At our first visit, we had the opportunity to meet Dr. McIntosh, who acknowledged and comforted our fears,” Stacy says. “The fact that the brace is made onsite and adjustments can be done anytime is such a gift to us.”

In Kathlynn’s case, brace wear came with the fear of being taken away from her passion —dance. Dr. McIntosh and her family agreed on all-day bracing for Kathlynn, with the recommendation to wear it 20 hours a day. With this plan, Kathlynn wears her brace to sleep and only takes it off for dance. While no limitations were placed on Kathlynn’s physical activities, adjusting to a scoliosis brace can be challenging physically and mentally. For Kathlynn, it encouraged her to work harder.

“Despite the physical demands that come from practicing and performing, Kathlynn never lets scoliosis define her,” Stacy says.

While Kathlynn’s journey is not over, she continues to handle bracing with grace. “Scottish Rite has given us more than medical care,” Stacy says. “They’ve given us hope, education and a clear plan. We’re especially grateful for how the team speaks directly to Kathlynn, helping her feel seen and heard. That connection and level of trust have made a huge difference in her commitment and growth.”