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Scoliosis

The NYU Hospital for Joint Diseases Center for Children utilizes minimally invasive and state-of-the-art techniques to achieve the best cosmetic and functional outcomes in children and adolescents with scoliosis.  The Hospital for Joint Diseases Center for Children is part of a nationwide study in the use of bracing and Scoliosis and, is at the forefront in advances and treatment of this condition.

Definition
Scoliosis is a condition in which the spine curves and, can cause low back and leg pain. Usually, the reason scoliosis occurs is not known. In most cases, Scoliosis develops in childhood, though it may not be diagnosed until the teen years.

Causes
The cause of the majority of Scoliosis cases cannot be identified but sometimes a disease in utero that affects the neuromuscular system can be thought to be a cause.

Risk Factors
Because the cause of scoliosis is unknown in the majority of cases, there are currently no known ways to reduce the risk of Scoliosis.

Symptoms
Scoliosis can be diagnosed during a physical exam. A child with more severe degrees of curvature scoliosis may have noticeable symptoms such as:

  • Uneven shoulder blades
  • Uneven hip bones
  • Shoulder blades or ribs more prominent on one side
  • Back pain

Diagnosis
As mentioned, Scoliosis can be diagnosed during a physical exam. Other tests include:

  • X-rays:  The x-ray can identify the presence of Scoliosis
  • Forward Bend Test:  The child is asked to bend forward with the doctor behind and the child can be checked for curvature of the spine or uneven appearance

Treatment
Surgical Care
Treatments used at the Hospital for Joint Diseases Center for Children, Video-Assisted Thoracoscopic surgery, and the Posterior Pedicle Screw are minimally invasive. Thoracoscopic surgery uses an endoscope (a small, narrow flexible tube which transmits an image to the viewer) to look at the spine and surrounding area with small incisions being made to put spine-straightening rods in place. The Posterior Pedicle Screw is also an important advance in the surgical treatment of scoliosis which allows for more correction with less slippage of the screws and no disturbance in the patient’s muscles and tendons. There is usually no need for bracing and the individual can return to normal activity and even playing sports in six weeks. In severe cases, your doctor may recommend surgery to correct a curve or, stop it from worsening if the patient is still growing.

Non-surgical Care
The doctor can monitor the curve by examining the patient every three to six months if the patient curve is less than 20 degrees or if the patient is almost done growing. Then, if necessary, bracing is done in order to prevent the curve from getting worse. Your doctor may recommend that the patient wear a back brace if still growing and if the curve is more than 20 degrees. Once the patient stops growing, the need for more treatment will depend on the size of the curve and how it affects the patient’s appearance and function.

Prevention
There is no known prevention for Scoliosis.

Case Examples
Click here to see photos of Tanner, one of our patients.

Patient Testimonials
Samantha
My name is Samantha Kaplan. In May 2007, I was diagnosed by Dr. David Feldman with Scoliosis that would require surgery. Dr. Feldman assured me that after surgery my Scoliosis would be corrected and I would be able to do everything that I was able to do before. However, he first encouraged me to go to sleep-away camp, which, after following his advice, I had an amazing summer. At the end of August Dr. Feldman performed spinal surgery on me. After staying in the hospital six days, I returned home and within only three more weeks I went back to school. Shortly after that, I was back to dancing and even made the school volleyball team, followed by the basketball and softball teams. Dr. Feldman's prediction was true. He is such a great doctor who was able to do a such a great thing for me! You would never be able to tell that I had a spinal fusion only nine months ago! Thank you so much Dr. Feldman!
Samantha Kaplan

Resources

Also see: Scoliosis

The Wallace B. Lehman, M.D. Center for Pediatric Orthopedic Surgery
http://www.nyuhjd.org/hjd/centerforchildren/patient/wallace.html

The New York Institute for Limb Lengthening and Reconstruction http://www.nyuhjd.org/hjd/centerforchildren/patient/limb.html

The Center for Pediatric Rehabilitation and Pediatric Medicine
http://www.nyuhjd.org/hjd/centerforchildren/patient/ped_rehab.html

The NYU Hospital for Joint Diseases Pediatric Physical and Occupational Therapy Department
http://www.nyuhjd.org/hjd/centerforchildren/patient/rehabilitation.html

Child Life Program at Center for Children
http://www.nyuhjd.org/hjd/centerforchildren/patient/child_life.html

Music Therapy at Center for Children
http://www.nyuhjd.org/hjd/centerforchildren/patient/music_therapy.html

 

To make an appointment at the NYU Hospital for Joint Diseases Center for Children, please call 212-598-6205