Ask the Expert
Muscle strain or overuse from dancing, sports or other physical activities may
but are defi nitely not caused by carrying heavy things, athletic involvement, poor posture or leg problems. There are three kinds of idiopathic scoliosis based on age: infantile, adolescent and adult. It’s most common in adolescent girls. The examination for scoliosis is usually done at yearly well-child visits with a pediatric healthcare provider. The exam starts by just looking at the back while the child is standing with hands down at the sides. The provider is looking for curvature of the spine, unevenness in the shoulders or shoulder blades, or a shift in the trunk to the side. Once that part of the exam is complete, the child is asked to bend over at the waist while the arms hang down loosely. This position allows the provider to identify any unevenness of the back and use a small plastic level called a scoliometer. This instrument will help the provider decide if X-rays of the spine are needed in order to measure how signifi cant the curves of the spine might be. The treatment of scoliosis depends on the child’s age and severity of the curves.
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Treatment options for idiopathic scoliosis include observation, bracing and surgical treatment. Small curves of the spine while the child is still growing or moderate curves (less than 40 to 45 degrees) once child has stopped growing usually only need observation. Bracing to prevent the curve from getting worse is used when growing children have curves between 25 and 45 degrees. The brace will not correct the curve. Surgical treatment is used when there is rapidly changing scoliosis in a young child or there is more than a 50-degree curve in adolescents. The surgery includes putting metal rods, plates and screws into the spine so that the spine will be straight and the scoliosis will not progress any further. Careful evaluation is important if your
child has pain back pain that won’t go away or seems to be getting worse, or there are concerning associated symptoms.
Ann Petersen Smith, PhD, APRN, CPNP-PC, CPNP-AC, is an Assistant Professor at the University of Colorado Anschutz Medical Campus College of Nursing.
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