1.       Is there another option for my child’s scoliosis other than watching and waiting?

The most dangerous game a patient of any progressive condition is to sit around and do nothing. This gabling approach has been the standard operating procedure for decades with a very small rate of success and even that small percentage of kids that don’t get worse watching and waiting certainly didn’t improve their scoliosis. Although your doctor will tell you most cases don’t progress and maybe even throw out a percentage like 60 or 70%, keep in mind that a 20-30 degree thoracic or lumbar scoliosis can produce visible postural deformity, and influence functional biomechanics enough to alter degenerative changes of discs and produce pain in the future. The answer to the question when asked should be a resounding YES! There is absolutely something you can do proactively to help minimize the risk of progression and potentially even eliminate a smaller curve. The problem with the orthopedics is that they are limited to medical procedure and exposed most often to surgical research in their journals so they might not even be aware that new innovations in the area of early stage scoliosis treatment are available through highly trained rehabilitation specialists like myself and Dr Stitzel who have created the “Early Stage Scoliosis Intervention” program for this purpose.

2.       Is there a genetic test that can help assess risk of progression?

Most competent pediatricians and orthopedic surgeons are aware of the scoliscore test and its purpose. All Caucasian children diagnosed with mild scoliosis that are and between 9-13 years of age should have this simple insurance approved saliva test performed which indentifies their risk of progression to surgical levels with an impressive 99% accuracy rating. This allows the doctor to create a much more customized plan of action depending on their score.

3.       Are there any potential side effects from wearing a scoliosis brace?

The most commonly used treatment for scoliosis curvatures between 20-40 degrees is the rigid scoliosis brace. It is prescribed like an aspirin for a headache. The absolute lack of knowledge and conversation that takes place regarding rigid orthosis for scoliosis is appalling. This is one of the most controversial topics in the world of scoliosis treatment and there are just as many studies proving its ineffectiveness as there are proving its effectiveness but yet it is still the go to option for medical providers nationwide. Rigid bracing is also utilized on all curve types and has been statistically proven to be completely useless for certain types of scoliosis especially upper thoracic curvature. In addition scoliosis braces produce significant decreases in breathing capacity while in the brace and have been shown to cause psychological trauma in adolescents.

4.       Should I get an MRI performed?

According to recent literature as many as 20% of thoracic curvatures have positive MRI’s for chiari malformation or cord tethering and are no longer classified as idiopathic. If your child has a high thoracic curve get an MRI done to rule out pathology. In the case where the thoracic curve is to the left always get an MRI to rule out syrinx formation or possible space occupying lesions.

5.       Are there any activities that can harm my child’s scoliosis?

Scoliosis is a multi-factorial condition which also involves environmental influences which can play a significant role in accelerating curve progression. Activities that involve extension of the thoracic spine like ballet, gymnastics, and yoga can increase shear forces on the thoracic spine which accelerates rotation. Prolonged neck flexion like texting, schoolwork, and computers can alter the normal sagital spine profile and create tension on the spinal neurological system which may increase instability and progressive behavior of scoliosis. A doctor should have common knowledge of these biomechanical principles and they should be explained to you and your child to avoid potentially throwing gasoline on a preexisting fire.