Scoliosis and Spine Center Diagnosis and Treatment
At the Children’s Andrews Institute Spine Center, our expertly trained pediatric orthopedic specialists use the most advanced imaging techniques available in the Dallas, Plano and north Texas area to diagnosis your child’s condition. Our experts use cutting-edge surgical and nonsurgical methods to treat pediatric scoliosis and other spine conditions in children and teens. But just as important, we’ll spend as much time with you as you need to be sure you understand your child’s condition, and to go over all the treatment options and choose the right one for your child.
Expert Scoliosis Diagnosis at Children’s Spine Center
All evaluations for scoliosis, spinal deformities or back pain issues start with a comprehensive assessment. A pediatric spine specialist will take a medical history and perform a thorough physical exam. If needed, your child will get an x-ray or another type of image of his/her spine. As a family-focused center, we understand the need to use x-rays cautiously on young, growing bodies.
After we complete our evaluation, our Spine Center team will develop a personalized treatment plan tailored to your child’s specific condition and needs.
Advanced Scoliosis and Spine Treatment Options
We always start with the most effective non-operative treatments and consider surgery only if necessary. Most children with spinal conditions will only need non-operative treatments to get them back to their normal, active lives.
- Observation: Children who come to the Spine Center with a slight curve, less than 20 degrees, require no immediate treatment. These children will only need to check in with a spine specialist on a regular basis to make sure the curve is not progressing. Our physicians will keep an eye on the curve until your child has stopped growing (around late puberty) to be sure other potential health problems don’t arise. If the curve progresses beyond 20 degrees, bracing may be necessary.
- Physical therapy: This is used to strengthen back and leg muscles. While therapy doesn’t treat underlying scoliosis or spinal deformity, or keep it from progressing, it can alleviate your child’s pain or discomfort. Our physical therapists are specially trained to work with children with spine problems, helping them strengthen muscles, increase flexibility and prevent injury.
- Bracing: If your child’s curve progresses past 20 degrees or is diagnosed when it is more than 20 degrees, wearing a brace can prevent the curve from progressing while your child continues to grow. To ensure this treatment is effective, it’s important that your child wears this brace a minimum of 18 hours a day. At the Spine Center, we dedicate time to educating our patients about the importance and goals of bracing. We work closely with an orthotist (a specialist who makes and fits braces) to ensure proper fit and comfort.
- Mehta casting: Mehta casting is most often used on infantile scoliosis patients. Pediatric orthopedic surgeon Dr. Christopher Redman trained with one of the country’s foremost experts in treating infantile scoliosis. He is one of the only surgeons in the state to use this treatment for early onset scoliosis patients . Mehta casting has been shown to be more effective than bracing for younger scoliosis patients.
When is surgery necessary?
One of the most common questions we get at the Children’s Health Andrews Institute Spine Center is: will my child need surgery? Fortunately, in most cases, the answer is no. Surgery is usually only considered for children whose spinal curves have progressed to more than 45-50 degrees. Surgery may also be considered for children whose curves are progressing rapidly.
We know surgery is scary. But parents can have peace of mind knowing that our pediatric orthopedic specialists are highly trained and use the most advanced surgical techniques available. We are the only pediatric facility in Texas, and one of the few in the country, to use robotic-assisted technology in the operating room. The Renaissance® Mazor Robot Guidance System is a cutting edge surgical tool that helps improve surgical outcomes.
The two primary goals of spine surgery are to:
- Correct a curve as much and as safely possible
- Stop a curve from getting worse. When a spinal curve advances to over 45 degrees, there is a risk that it will continue to progress 1 to 2 degrees a year. -That would mean a significant curve in adulthood, and one that is harder and riskier to correct. Additionally, a significant curve can lead to breathing and heart issues.
- MAGEC ™ Growing Rods: MAGEC Growing Rods are used for early onset scoliosis patients who are too young to undergo a spinal fusion but have significant curves. These rods can be magnetically lengthened via remote control, making them far superior to older types of rods that require repeated surgeries as the child grows.
- Spinal fusion: This is the most common type of spinal surgery used to correct a spinal curve and prevent it from getting worse. In spinal fusion surgery, vertebrae are fused together, usually with a bone graft, to prevent further curving. Rods and screws are placed to help keep the spine aligned while the bones fully fuse together. Renaissance® Mazor Robotic Guidance System helps improve accuracy for screw placement, potentially reducing complications. Once the bones are fused together, the spinal curve stops advancing. Most often, spinal fusion is done from the back of the spine (posterior approach). Less often, surgeons operate from the front (anterior approach).
- Vertebral resection: Vertebral resection is a rare procedure that is performed to further correct severe curves. It involves removing part or, in some cases, all of the vertebrae in the affected level of the spine.