Signs of scoliosis in adolescents are clear if parents keep an eye out - East Valley Tribune: Get Out

Signs of scoliosis in adolescents are clear if parents keep an eye out

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Posted: Tuesday, April 3, 2007 6:45 am | Updated: 6:05 pm, Fri Oct 7, 2011.

It didn’t take Pamala and Dwayne Bader of Mesa long to realize something wasn’t right with their 11-year-old daughter, Cheyene.

http://eastvalleytribune.com/images/photos/e8vhgh6o.jpg" rel="lytebox[]" class="content-link">View scoliosis graphic

At-home screening tips

This January, when a towel-clad Cheyene passed her father on the way from the shower to her bedroom, he noticed the left side of her back protruded more than the right. Concerned, he asked his wife to take a closer look.

“Her back looked almost swollen and the left side of her chest was sticking out a little further than the right side,” says Pamala Bader. She asked her daughter to touch her toes, then ran her fingers down Cheyene’s spine. “I said, ‘I think you have scoliosis.’ ”

The Baders scheduled an appointment with the family pediatrician, where an X-ray confirmed the fifth-grader’s condition, which causes the spine to curve 10 degrees or more while the vertebrae rotate within the curve.

Cheyene’s growing curve, which had remained hidden under winter clothing, had progressed to a serious 62 degrees. Before January, Bader says, they didn’t notice there was a problem.

“We didn’t know if she was going to have to wear a brace or get surgery,” she says, when they took their daughter to Dr. Mark Flood, founder and director of the Center for Spinal Disorders and Pediatric Orthopedic Surgery at Banner Desert Medical Center in Mesa.

The development of scoliosis in pre-adolescents, especially growing girls like Cheyene, is not uncommon. Flood says typically 4 percent of boys and girls in the pre-adolescent and adolescent population develop a form of scoliosis. Girls, however, are at greater risk for having the condition worsen.

“Larger curves are more common in girls by 10 to 1,” says Flood.

SCREENING GUIDELINES

The cause of scoliosis is unknown. Detecting it in its early stages is easy for parents to miss until, in cases like Cheyene’s, the condition progresses to the point of a protruding shoulder blade, rib or hip. To make matters worse, there are no universally adopted screening methods in the United States among physicians and school officials.

“The American Academy of Orthopaedic Surgeons recommends screening females at 11 and 13 and again between 13 and 14,” Flood says. “The American Academy of Pediatricians recommends screening both boys and girls at 10, 12, 14 and 16.”

Some schools don’t test children for scoliosis anymore.

By the time the Baders noticed their daughter’s back didn’t look right, they were told surgery would be the only option. (Cheyene’s school had scoliosis testing planned a few weeks after she was diagnosed.)

“She needs 10 to 11 vertebrae fused and two rods put in to hold her spine,” says Bader, who scheduled the procedure for early June so it doesn’t interfere with school.

WHAT TO DO NEXT

Not all children diagnosed with scoliosis will have to undergo surgery.

Brittany Volz, 13, of Chandler was recently diagnosed with a 13-degree curve during an annual exam.

“Once the doctor pointed out to me what he was seeing, you could see. Parents need to know what to look for,” says her mom, Julie Volz.

Since her curve is minor, Brittany was put on a watch list by her physician and will be monitored every three months for changes until her bones stop growing.

Flood says roughly 10 percent of the cases he sees require surgery.

Once diagnosed, the severity of the curve, the child’s age and years left toward skeletal maturity will determine the course of action. For example, if the curve reaches 25 to 30 degrees and the child has experienced a significant amount of growth, Flood says typically a child will be fitted for a brace, which they will have to wear 22 hours a day until their spine stops growing. That’s usually around age 16 for boys and age 14 for girls.

If the curve is between 40 degrees and 50 degrees and the child still has significant growth to come, Flood says surgery may be recommended. If a curve reaches 50 degrees and higher, surgery is typically the course of action for children and adults.

Flood says surgery won’t cure the condition, but can correct it by around 50 percent. “The goal of surgery is to prevent progression,” says Flood.

Bader says Cheyene’s condition is worsening. At a check-up three months after her initial diagnosis, the curve had increased another 8 degrees to 70 degrees. To slow the progression until her surgery, Cheyene will be put in a brace for the rest of the school year.

Bader says her daughter is hanging in there. “I think she’s scared, but I don’t think she realizes what this will cause if she doesn’t have surgery.”

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