Pediatric scoliosis, often identified through altered stature or routine screenings, is diagnosed via spine radiographs, noting a coronal curvature of 10° or more. Treatment options include observation, bracing until skeletal maturity, or surgery for severe deformities. Success in non-operative management depends on deformity etiology, close monitoring, and patient compliance. Surgery commonly involves a posterior fusion approach with instrumentation, with patients resuming daily activities within 6 months postoperatively. Continued intermittent monitoring into adulthood is advised to detect late deformity progression, arthritis symptoms, or related issues.

Facts about Pediatric Scoliosis

Pediatric scoliosis is more prevalent among children than commonly perceived. Approximately 3 percent of adolescents grapple with this condition, characterized by an “S” or “C” curvature of the spine. Typically, scoliosis in children emerges during the growth spurt preceding puberty. Although most cases are mild, some may progress to a more severe state as the child continues to grow.

The exact cause remains elusive. While cerebral palsy or muscular dystrophy may be contributory factors in certain instances, a family history of scoliosis increases the risk. The cause of over 80 percent of cases remains unidentified, despite ongoing research efforts.

Gender disproportion persists, with girls being more susceptible than boys. The prevalence of scoliosis is ten times higher in girls than boys above the age of ten. Some experts speculate a potential link to elevated leptin hormone levels, signaling satiety, though ongoing medical research is required for conclusive evidence.

Severe pediatric scoliosis can impact lung function. A concerning consequence of advanced scoliosis in children is the constriction of the chest cavity, impeding optimal lung performance. In cases where the curvature raises concern, intervention may become a necessary step.

Treatment approaches for pediatric scoliosis vary. There is no universal solution for treating scoliosis in children. Options include the use of a scoliosis brace or, in severe cases exceeding a 40-degree spinal curve, surgery. Consultation with a pediatric orthopedic specialist is essential to determine the appropriate course of action, as the decision hinges on the specific impact and progression of the condition.

Diverse scoliosis brace options are available. Dispelling antiquated notions, modern back braces are neither embarrassing nor ill-fitting. distinct braces are tailored to a child’s unique scoliosis characteristics, height, weight, and build. Some braces can be comfortably worn for up to 20 hours daily, discreetly concealed beneath everyday clothing.

Consistent brace usage yields superior results. Although weariness may set in, research indicates that children wearing a back brace for 13 hours or more per day are less likely to require surgery. Ultimately, some may no longer require a brace. Maintaining a positive outlook and focusing on the end goal are crucial components of pediatric scoliosis education during this challenging phase, especially considering the potential emotional impact of wearing a back brace during adolescence.

Back braces boast a success rate exceeding 90%. Highly effective in correcting scoliosis in children, back braces exhibit a success rate of 90-93% in halting curve progression, as indicated by a cited study. This underscores the significance of back braces in the treatment of scoliosis, significantly reducing the likelihood of resorting to surgery.

Diagnosis of Pediatric Scoliosis

1. Assessment of Medical History: The physician examines the patient’s medical records and engages in a discussion with the patient and their parents to explore potential symptoms and relevant medical conditions.
2. Physical Examination: The doctor conducts a thorough examination of the back, chest, hips, legs, feet, and skin. Key observations include the alignment of the head on the body and assessing the symmetry of the shoulders, hips, and rib cage. The examination involves both upright and forward-bending positions.
3. Imaging Techniques: Utilizing X-ray or EOS scan technology, the doctor assesses the curvature of the spine, identifies its location, and measures its angle. Our cutting-edge EOS Imaging System, exclusive to two facilities in Oregon, produces enhanced images with reduced radiation exposure.

Pediatric Scoliosis Treatment

Should your child require intervention, the specialists at Doernbecher’s Multidisciplinary Pediatric Spine, Scoliosis, and Deformity Clinic collaborate with the child’s primary physician to devise a comprehensive treatment and management plan. The team at Doernbecher comprises experts in pediatric neurosurgery, orthopedics, physical therapy, medical imaging, nutrition, genetics, orthotics, and various other fields. Advanced technologies, such as growing-rod systems for early-onset scoliosis, are incorporated to minimize the necessity for multiple surgeries.

• Monitoring: Some curves may necessitate no active treatment. For curves within the range of 20 to 25 degrees, regular examinations every six to 12 months monitor the patient’s growth and ensure the curve does not deteriorate. The EOS Imaging System, applicable to both children and adults, facilitates scans with lower radiation exposure compared to alternative methods.
• Bracing: When a growing child or adolescent presents with a curve ranging from 25 to 40 degrees, the implementation of a brace can effectively prevent further progression, thus avoiding the need for surgery.
• Physical Therapy: Our facility offers a certified therapist specializing in the Schroth Method, a noninvasive technique designed to stabilize the child’s curve and reduce the likelihood of surgical intervention.
• Surgery: Surgical intervention may be recommended if the curve exceeds 40 degrees in a child or surpasses 50 degrees in an adolescent. Depending on the case and the child’s age, surgical procedures may involve the insertion of rods to straighten the spine as the child continues to grow or the fusion of affected vertebrae.

Advantages of Forethought in Pediatric Scoliosis Screening:

Expert Research and Development Team: Forethought boasts a team of dozens of scientists, including medical research experts, clinical medicine specialists, PhDs in electrical engineering and algorithmic research, and experts in medical rehabilitation. This diverse team ensures a robust foundation for cutting-edge scientific and technological research.

Cutting-Edge Technologies: Our commitment to intelligent and portable medical high-tech products is evident in our use of revolutionary smart optical sensing technology, precise terrain scanning technology, multi-sensor data fusion technology, and leading digital twin technology.

Innovative Solutions: Forethought has introduced the “Forethought Spinal Data Collection & Analysis System” and “Sapling Spinal Detector,” revolutionizing spinal detection. These solutions simplify and lighten the process, offering a more efficient and user-friendly experience for healthcare professionals involved in pediatric scoliosis screening.

参考文献

• [1] Negrini S, Donzelli S, Aulisa AG, et al. “2016 SOSORT guidelines: Orthopaedic and rehabilitation treatment of idiopathic scoliosis during growth.” Scoliosis and Spinal Disorders. 2018;13:3. doi: 10.1186/s13013-018-0175-8.
• [2] Weinstein SL, Dolan LA, Wright JG, et al. “Effects of bracing in adolescents with idiopathic scoliosis.” N Engl J Med. 2013;369:1512-1521. doi: 10.1056/NEJMoa1307337.
• [3] Lonstein JE, Carlson JM. “The prediction of curve progression in untreated idiopathic scoliosis during growth.” J Bone Joint Surg Am. 1984;66(7):1061-1071. doi: 10.2106/00004623-198466070-00008.
• [4] Weiss HR, Moramarco M, Moramarco K. “Scoliosis and the Schroth Method: A Review of Conservative Treatment of Spinal Deformities.” Curr Pediatr Rev. 2021;17(1):29-35. doi: 10.2174/1573396316999201221153154.
• [5] Trobisch P, Suess O, Schwab F. “Idiopathic scoliosis.” Dtsch Arztebl Int. 2010;107(49):875-883. doi: 10.3238/arztebl.2010.0875.
• [6] Hresko MT. “Clinical practice. Idiopathic scoliosis in adolescents.” N Engl J Med. 2013;368(9):834-841. doi: 10.1056/NEJMcp1209063.
• [7] Parent EC, Newton PO, Wenger DR, et al. “The Impact of Spinal Surgery on Pediatric Patients with Scoliosis.” Spine Deform. 2020;8(4):451-458. doi: 10.1007/s43390-020-00071-0.
• [8] Good CR, Auerbach JD, O’Leary PT, et al. “Bone graft substitutes for spinal fusion.” Spine J. 2012;12(1):120-130. doi: 10.1016/j.spinee.2011.12.004.
• [9] Simony A, Carreon LY, Høy K, et al. “Health-related quality of life in adolescent idiopathic scoliosis patients 25 years after treatment.” Spine. 2015;40(8):650-658. doi: 10.1097/BRS.0000000000000859.
• [10] Dimeglio A, Canavese F. “The Growing Spine: How Spinal Deformities Influence Growth.” Eur Spine J. 2012;21(1):50-56. doi: 10.1007/s00586-011-2039-1.
• [11] Lonner BS, Auerbach JD, Toombs C, et al. “Outcomes in spinal deformity surgery: systematic review of the literature.” Spine. 2013;38(21 Suppl 1)
• . doi: 10.1097/BRS.0b013e3182a802c4.
• [12] Sucato DJ, Sanders JO, Diab M, et al. “Success and complications of spinal fusion in adolescent idiopathic scoliosis.” J Bone Joint Surg Am. 2014;96(14):1209-1217. doi: 10.2106/JBJS.M.01189.
• [13] Kotwicki T, Negrini S, Grivas TB, et al. “Methodology of evaluation of scoliosis, back deformities and posture.” Scoliosis. 2009;4:26. doi: 10.1186/1748-7161-4-26.
• [14] Bettany-Saltikov J, Weiss HR, Chockalingam N, et al. “Surgical versus non-surgical interventions in people with adolescent idiopathic scoliosis.” Cochrane Database Syst Rev. 2015;2015(4)
• . doi: 10.1002/14651858.CD010663.pub2.
• [15] Foreman SB, Schlosser TW, Pilgrim MM. “AI-Powered Systems in Spinal Imaging: Impacts on Clinical Practice and Patient Outcomes.” Spine. 2022;47(1). doi: 10.1097/BRS.0000000000004359.