A scoliosis is an abnormal spinal curve that develops while a child is growing. They usually start out small and worsen when the child is growing most rapidly. It was discovered in the 1980’s that the cause is genetic, which is why it can be found to run in families.
Essentially, the spine grows from a number of areas. The genes turn growth on and off in spurts throughout childhood. In scoliosis, the timing of the growth signal is abnormal. Portions of the spine are stimulated to grow while others are delayed or turned off. The end result is a spine that begins to twist as it grows. This may cause a minor curve not easily detectable without x-ray, or a visible hump.
Scoliosis can become severe, damaging the heart or lungs requiring life saving surgery.
There are a few important points in dealing with a child who has scoliosis. Early detection is important so that rapidly developing curves can be caught before they lead to organ damage. For non-surgical cases that are resulting in significant spine deformity, bracing has been the treatment of choice.
The idea had been to force the body straight by encasing the trunk in a hard plastic corset that shoves the curves in the right direction. Unfortunately, this treatment has not provided satisfactory results. Some sources indicate no more than a 20% improvement with the Boston brace, one of the standards in care until now. Serious complications from the use of typical scoliosis braces include muscle wasting, pressure sores and pain from wearing the apparatus. Needless to say, children who have to wear such a device are not happy campers and often quit treatment early.
With the understanding of the genetic cause of scoliosis, a new type of brace has been developed that is more comfortable, has fewer side effects and is far more effective than the older braces. Instead of rigidly fighting the curves, it stimulates the slower growing areas of the spine and gently pulls the spine in the proper direction of growth. Simple elastic straps connecting spandex type shorts and a thin nylon vest do all the work.
The gentle pushing and pulling of the straps during normal movement has the effect of stimulating spinal growth even if the genes are not telling the spine to do so. As many as 70% of wearers can have their curve improved with this brace, with a very significant amount achieving near total correction.
Success of course depends on the nature of the patient and the curve. The younger the patient is when starting care the better, although bracing is not recommended for kids under five years old. The smaller the curve is and the slower the child’s’ growth, the better the odds of a good result. Typically one doesn’t brace unless the curve between 15-50 degrees. However, differences do occur in measurements. Your radiologist has the option of several measurement techniques, so an evaluation specifically for this type of brace is essential.
Lastly, you can only truly correct a curve that is still growing, so the process really works best when their skeletons are immature. If the child is nearing puberty, time is short.
Why try such a brace at all? The most urgent reason for many is preventing a major surgery. For others, reducing a visible deformity is their motivation. From my perspective as a chiropractor, it is prevention. Prevention of the inevitable arthritis, muscle tightening and messed up movement patterns that will inevitably develop from a scoliosis. As the years go by, abnormally short and long muscles, combined with spine joint deterioration often result in people with chronic, persistent pain. It is easy enough to end up that way when your back starts out straight.
Imagine the price your children will pay when saddled with a deformity from birth. Truly, an ounce of prevention is worth as pound of cure.