Dr. McIntosh talking about early onset scoliosis on Facebook live.

Jun 20, 2018 / Scoliosis & Spine

#SRHaccess Facebook LIVE Recap: Early Onset Scoliosis

In honor of Scoliosis Awareness Month, staff orthopedist Amy L. McIntosh, M.D., joined us on Facebook live to discuss early onset scoliosis. Below is a recap of the conversation.

Watch the live segment. 

What is early onset scoliosis (EOS)?
  • A child who is diagnosed with scoliosis before the age of 10.
  • There are different reasons/causes of early onset scoliosis.
    • Idiopathic – scoliosis forms from unknown cause
    • Congenital – vertebrae didn't form correctly while still in the womb 
    • Neuromuscular/syndromic condition that causes a muscular imbalance and can result in scoliosis
How is early onset scoliosis diagnosed?
  • Majority of patients are diagnosed very early after birth. The vertebrae didn’t form correctly and there are potentially other underlying medical conditions associated with the scoliosis. 
  • In other cases, a family member notices a prominence on the child’s back. On average, a parent or guardian notices a deformity of the spine as they hit various developmental milestones (sitting up or crawling). 
Options for Treatment:
  • Casting – great option for young children (1-5 years of age)
    • In certain types of scoliosis, the curve can be cured through casting curves over 50 degrees by slowly pulling the spine straight.
    • Only treatment option that does not include surgery or putting metal in the spine to correct the curve.
    • Child is put under anesthesia to apply the cast and due to rapid growth during this time, it’s changed every few months. 
    • About 30% of patients’ spines can be straightened with casting. However, for the other 70%, casting is used to help slow down the growth/severity of the curve. 
  • Bracing 
    • However, it can be difficult to brace young children because of their size and the fact that they are growing very quickly.
  • MAGEC rods – magnetic rods that are placed surgically in the patient's spine. This is a less invasive treatment option that decreases the amount of surgeries a child must undergo. The rod is then lengthened in clinic with a device that expands the rod in the patient’s back. 
  • Definitive fusion 
  • Halo gravity traction – a technique used before performing spine surgery.
    • A halo ring is implanted in their skull with pins.
    • Traction is slowly added to gradually straighten out the spine.
    • Patients are able to be upright and walking.
    • On average, the traction can be up to half or 80% of the patient’s body weight.
    • 30-40% correction of the spine deformity while in traction.
    • Once time in traction is complete, patients undergo surgery to correct the remaining deformity in the spine. 
    • Traction makes surgery safer and improves pulmonary function.
Research in Early Onset Scoliosis
  • GSSG – Growing Spine Study Group: a group of doctors that represent hospitals all over the world who are dedicated to finding innovative techniques to treatment for scoliosis. Scottish Rite Hospital doctors are members of this group. 
  • If a patient has EOS, he or she will be approached by a research team member while in clinic to enroll in the prospective database. 
  • Doctors and researchers will follow the patient throughout their treatment and will record data at each visit. 
  • Our experts want to know how various treatments effect the child and the family long term. 
  • By collecting data and functional outcome scores through questionnaires from the patients, it helps our experts see the progress/effectiveness of the treatment from the patient’s perspective. 
  • Once those patients who are enrolled in research complete their treatment, he or she will participate in a study where they will be put on a treadmill to measure their oxygen capacity and see how they function from a heart and lung perspective. With this data, the outcomes from these patients are then compared to those of their peers. 

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