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Scoliosis: An Unnatural Curve
Date:5/11/2008

de, one shoulder appearing higher than the other, or the pelvis seeming out of alignment.

The diagnosis can usually be made from a physical exam, but most of the time, a spinal X-ray will also be done to confirm the diagnosis and more accurately assess the degree of the curve. Knowing the exact degree of the curve is important because it helps to guide treatment decisions.

"Right now, treatment is based on curvature," explained Dr. Vincent Deeney, an orthopaedic surgeon at Children's Hospital of Pittsburgh. For curves under 25 degrees, treatment is usually just observation, he said.

"For 25 to 40 degree curves, brace treatment isn't designed to get rid of a curve, but to keep it from getting worse," Deeney explained. There are a wide variety of braces available that shouldn't affect a child's social life, and they can be taken off so the child can participate in physical activities.

Both Deeney and Grayhack said that once a curve reaches 45 degrees, that's when it's time to consider surgery.

But, said Grayhack, "back surgery is a big deal. The surgery straightens out the spine and we try to hold it in place, usually with rods that are held in place with screws or hooks. The bone then fuses around the rods and you lose some flexibility in your spine."

Grayhack said some surgeons are using staples to straighten the back, and this method may help to maintain flexibility. But this is "cutting-edge" surgery right now, and not as well-studied as other methods, he noted.

There doesn't appear to be any way to prevent scoliosis, and Grayhack said that numerous studies have been done using exercise programs and other methods, but none has been found effective yet.

More information

To learn more about scoliosis, visit the American Academy of Orthopaedic Surgeons.




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