Ask Dr. Marla: How is scoliosis diagnosed and treated?



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My daughter’s ballet teacher thinks she might have scoliosis. How is this diagnosed and treated?

Answer:

The term scoliosis refers to a curvature of the spine in the shape of either a C or an S (with a curve in one direction at the top of the spine and a curve in the other direction at the bottom of the spine). As the spine curves, the ribs move with it. Depending on the extent of the curve, scoliosis might go unnoticed. The diagnosis is suspected at the time of a physical exam. Your doctor will look to see if the shoulders are at the same height and will ask your child to stand and bend forward to examine the spine.

We diagnose scoliosis with an X-ray. The radiologist reports the extent of the curve by degrees. According to SickKids Hospital in Toronto, the diagnosis is made when the curve is greater than 10 degrees and we see a twist or rotation in the spine. If there is a single curve – a so-called C curve – we consider it small if it is less than 20 degrees. A moderate curve is between 20 and 50 degrees; a curve greater than 50 degrees is considered large.

The risk for progression of the curve is greatest when your child is still growing. If she has not started to menstruate then there is also a higher risk of the curve getting bigger.

The first suggestion is to have your doctor examine your daughter and do an X-ray. If the curve is small, then watchful waiting is the course we usually undertake with repeat visits and monitoring through X-rays on a regular basis. In some instances a custom-fit brace is made to mold to the body. Depending on age and stage, the brace may be worn for several years. It is somewhat controversial as to whether the brace does stop progression. Surgery is recommended for large curves.

While we do not know why scoliosis develops, it can run in families. Have your daughter checked by her physician.

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Originally published in ParentsCanada magazine, August/September 2012.

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