Scoliosis is a spine condition that affects approximately 2% to 3% of the global population, according to the American Association of Neurological Surgeons. Whether you have scoliosis yourself or know someone who does, read on to learn more about the condition, its types and causes, common symptoms and treatments, how it can affect mental health and more.
Meet Beau, a patient who is seen by our team of multidisciplinary experts. Learn more about his journey below.
Blogs written by Beau and his mom, Courtney.
When Beau was 6 months old, he was placed in the Chinese orphanage system, and our family adopted him in 2017, when he was 4 years old. We did not know much about his history, as he lived in a very large orphanage and information was not passed along. We did know he would be somewhat of a medical mystery and booked his appointment with our pediatrician before we even left China.
Beau is a complex patient, and after a variety of appointments and tests, he was eventually diagnosed with a form of dwarfism called spondyloepiphyseal dysplasia congenita (SEDc) and a monoallelic mutation of COL2A1 gene. This is a rare genetic disorder that impacts different parts and systems of his body, including his eyes, hearing, spine and more.
In May 2021, Beau’s spinal curve rapidly started to increase, and that is when our orthopedic surgeon in Houston referred us to Scottish Rite for Children. We really love and trust our doctor in Houston, so it was very comforting to hear him say, ‘If my kid needed this done, where I’m sending you is where I would go. They are my number one choice.’ My anxiety as a mom went away, and I immediately started to research everything I could. We took the first available appointment and met Dr. Johnson for the first time at the end of June. She gave us a game plan for surgery, and we left with a sense of peace about the journey we were about to take with Beau at Scottish Rite.
In January 2022, Beau had spinal surgery and was in halo decompression for the next five weeks. Halo-gravity traction is the process of using a metal ring, or halo, attached to a child’s skull that applies traction to the spine, gently stretching and straightening out the spine to correct curvatures. – Courtney
I had so much fun in my halo, and my mom decorated my equipment, which made it even more fun! My walker was Mardi Gras-themed the entire time. I always had beads to hand out, and sometimes I even had a speaker playing Mardi Gras music!
My wheelchair was first decorated as the emperor’s throne, because of Chinese New Year, and I handed out handmade fortune cookies. I created all the sayings, and my mom made paper cookies. I even painted my face like a tiger, because we are in The Year of the Tiger.
For Valentine’s Day, my decorations were full of hearts, lights and sparkles. I had a cool shirt that said, ‘Just call me Cupid’ and wore an awesome red top hat with heart glasses. My mom and I made over 350 valentines, and we handed them out around the hospital. I know that there are a lot of people that are needed to make hospitals run smoothly, and I tried to meet all of them. I wanted to remind them that they are important, and I was thankful for all they did during my stay.
After surgery, I went home in a wheelchair. My farewell theme decorations were Oh, the Places You’ll Go! My mom said that this was a perfect theme to represent moving from China to the United States. Not only did I have to learn and adapt to a new world, but because of my spine surgery at Scottish Rite, I also have a new level of life, and nothing is going to hold me back!
I feel like I will be able to do anything I set my sights on, thanks to different people at Scottish Rite. The Therapeutic Recreation department allowed me to participate in sports and games that I never thought I would be able to do. My size can make sports hard, but they showed me how I could fully participate with just minor modifications.
When I was an inpatient, Ms. Dana gave me my very own Learn to Golf set of golf clubs, and we had a special visitor during therapeutic recreation – Mr. Carlos. He taught me how to play golf, plus he had a huge smile, was super nice, and has a special leg. We live near a golf course, and I have always wanted to learn how to play, but because of my size and my back, I never thought I would be able to participate. Mr. Carlos worked with me, and I learned how to make adjustments and was able to swing a golf club and hit the ball. After my big surgery, he even came to check on me. Learn to Golf will allow me to keep playing the sport and has connected me with special coaches, just like Mr. Carlos.
I am now back home in Houston and feeling good. I will always remember Scottish Rite for Children, and I look forward to my checkups because I can visit my friends all around the hospital, and they always remember my name!! – Beau
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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 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.
My back continued to curve at a very fast rate, so my original surgery date was moved up. I was scared, but I really wanted the surgery to be over with. And sure enough, less than three months after finding out that I needed surgery, it was done. Looking back, the waiting was hard, but everything went really fast. I had lots of appointments to get ready for surgery, making sure everything was planned out.
For me, making sure my true identity was understood, was another very important part. I am a transgender 13-year-old boy. I have a really hard time when I am misgendered. Getting my preferred gender and name to be used has been a battle at other places. Making sure my identity was honored was a priority for me and was a priority for the team at Scottish Rite. It’s hard enough being in the hospital without being misgendered.
Hearing that your child needs spinal surgery for scoliosis brings a flood of questions and a lot of uncertainty. Using the newest technology and innovative methods, the experts at Scottish Rite for Children are some of the best pediatric orthopedic surgeons in the world. Our leaders support your child throughout treatment, making their spinal surgery a success from start to finish.
We provide a multidisciplinary, patient-centered approach to scoliosis treatment. Spinal maturity; the degree, extent and location of the curve; and the potential for progression are all considered when determining treatment.
Types of Scoliosis
Additionally, scoliosis can be categorized by the following:
When Surgery is Needed for Scoliosis
Depending on the child and the severity of their curve, surgery may be the best treatment option. While not all cases of scoliosis require surgery, the following factors are an indication that surgery is needed:
The most common type of surgery performed for scoliosis is 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, hooks 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.
Having Spinal Surgery at Scottish Rite
Led by Daniel J. Sucato, M.D., M.S., our Center for Excellence in Spine employs six pediatric orthopedic surgeons who specialize in spinal surgery for scoliosis. Our diverse team of surgeons works together to create individualized treatment plans for each patient and ensure that the child and the family know what to expect each step of the way. Multiple departments work together to provide a multidisciplinary approach to care and treatment. Orthopedics, Psychology, Physical Therapy and more will address all your child and their needs to ensure they are prepared for surgery. Our psychologists help our patients cope with having surgery and address their feelings about their procedure, giving children the opportunity to express their emotions. Following surgery, our team works with your child to make recovery as easy as possible.
Tackling the Most Complex Cases
New and innovative techniques allow our experts to tackle the most difficult cases. This includes Magnetic Expanded Growth Rods (MCGR), Halo Gravity Traction (HGT), Vertebral Body Tethering (VBT), and Posterior Spinal Fusion (PSF). Our experts have experience treating complex cases, such as treating patients with a curve of over 100 degrees.
Road to Recovery
Following surgery, our team begins the recovery process with the patient. Using different pain management techniques. Our physicians are dedicated to seeing each patient through their recovery.
After a spinal fusion, it is common to need to minimize bending or heavy lifting. Our surgeons will go over limitations and discuss the importance of proper aftercare. Our team works with each patient to determine readiness to return to activities and coaches them through the recovery process.
How to Learn More and Become a Patient
Learn more about our Center for Excellence in Spine and scoliosis treatment.
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