Treatment for Children’s Scoliosis in Metro Detroit
Scoliosis is a curve in the spine of more than 10 degrees. Scoliosis is typically first noticed visually by the patient, a parent or family member, or their pediatrician at well-child visits on physical exam. Scoliosis is not just a curve of the spine when looking at an XR. The spine also twists within the curve. This causes ribs and muscle to become more noticeable on one side of the body. This typically leads to an XR ordered by the pediatrician or a referral to see a pediatric orthopedic surgeon.
The cause of scoliosis is not fully known. There are multiple types of scoliosis. Infantile scoliosis occurs in patients less than 4 years old. Juvenile scoliosis occurs in patients aged 4 to 10 years old. These types of scoliosis occur much less commonly than adolescent scoliosis. Dr. Minnock has expertise in the latest technology to address scoliosis in this group, including non-operative and operative treatments. Some patients with small curves require observation with repeat XR images every 6 months – 1 year. Others with larger curves require treatment with bracing and sometimes Mehta casting for very young patients. Others with even larger or progressive curves with require surgery with growing rods. This allows the spine to continue to grow with the patient. Spine growth in the thoracic spine (mid-back portion) where the ribs attach is important for lung development. If patients need surgery for larger curves, then the spine is usually fused at the top and the bottom over a small segment. This allows the spine in between to grow and lengthen with the child over time as the child grows. Traditional “growing rod” spine surgery placed rods that required repeated lengthenings of the rod connectors every 6 months in the operating room. This required 2 surgeries (with general anesthesia) for the child each year while undergoing lengthening. These rods work well and are still appropriate for certain spine curve deformities. Many patients can be treated with a new technology though – magnetically lengthened rods (MAGEC rod by NuVasive). These rods “grow” with the child as well, but they do so by a magnetic field to lengthen the rod instead of surgery. This magnetic lengthening field is generated by a small machine that Dr. Minnock uses in the office. The lengthening typically takes 1-2 minutes and is painless.
The most common type of scoliosis is adolescent scoliosis. This occurs in children over 10 years old. Curves are most commonly idiopathic, meaning we don’t know what causes them. Treatment depends on the amount of growth that the patient has remaining and how large the curve(s) measure on XR. Most of the time, there is a main scoliosis curve and a smaller curve above or below to help balance the spine. In general, if a patient still has a lot of growing left and has a curve 25 degrees or more, they are treated with a brace. Dr. Minnock works closely with an expert orthotist/prosthetist to make sure the brace provides good correction and fits well.
Other forms of scoliosis include: