Scoliosis

Symptoms & Causes Diagnosis & Treatment Doctors

How Is Scoliosis Diagnosed?

Diagnosing scoliosis involves thorough physical and neurological examinations, as well as advanced imaging techniques to confirm the condition and assess its severity.

Physical and Neurological Examination

The diagnostic process typically starts with a physical exam conducted by a neurologist or orthopaedic spine specialist. The healthcare professional will assess:

Review your child’s medical history and recent growth patterns.
Ask your child to bend forward from the waist, allowing the specialist to check for uneven rib cage alignment.

A neurological exam may also be conducted to evaluate:

Muscle strength
Reflexes
Numbness or sensation issues

These evaluations help determine if the spinal curve is affecting the nervous system or causing functional impairments.

Imaging Tests for Scoliosis

Imaging plays a crucial role in confirming the diagnosis of scoliosis and determining the severity of the curve.

X-rays

Primary Purpose: X-rays are the gold standard for confirming scoliosis and measuring the degree of spinal curvature.
Monitoring Progression: For children experiencing growth spurts, X-rays may be recommended every six months to track changes in the curve.
Low-Dose Technology: To reduce radiation exposure, many advanced scoliosis care centres now use specialised low-dose X-ray imaging systems, ensuring safer diagnostic practices.

Hand X-rays

Growth Assessment: Hand X-rays are often used to evaluate growth potential by examining the status of growth plates. Open growth plates indicate that the child is still growing, which can influence treatment decisions.

MRI Scans

An MRI scan is particularly helpful if there are concerns about spinal cord abnormalities or if the doctor suspects the curve may be related to another condition, such as spinal cord tumours.

Non-radiative: MRI scans use magnetic fields and radio waves instead of radiation, making them a safer alternative to X-rays.

Treatment Options for Scoliosis

Treatment for scoliosis varies depending on the severity of the spinal curve, the age of the patient, and the growth stage. The treatment options can range from non-invasive methods like bracing to surgical intervention in more severe cases.

Monitoring for Mild Scoliosis

Who it’s for: Children with mild scoliosis or adolescents nearing skeletal maturity may only need regular monitoring.

Regular check-ups with X-rays to track curve progression.
Treatment may not be necessary unless the curve worsens.

Bracing for Moderate Scoliosis

Bracing is recommended for moderate scoliosis in children whose bones are still growing. The goal of bracing is to prevent the curve from worsening.

How Braces Work:

Design: Braces are typically plastic, moulded to fit under the arms, around the rib cage, and lower back.
Usage: Most braces are worn 13–18 hours per day, depending on the severity of the curve.
Effectiveness: Wearing the brace as recommended can significantly help in controlling the progression of the curve.

Types of Braces

Day Braces: Worn during the day, typically discreet enough to be hidden under clothing.
Night Braces: Worn while sleeping and suitable for certain types of scoliosis.

When to Stop Bracing:

Growth Completion: Bracing typically ends once skeletal growth is complete, usually around 14 years for females and 16 years for males.

Surgical Treatment for Severe Scoliosis

In cases of severe scoliosis or if the curve worsens despite bracing, surgery may be required. Surgical options include:

Spinal Fusion

Spinal fusion is the most common surgical treatment for scoliosis. It involves the fusion of several vertebrae to straighten the spine.

Procedure: Bone grafts or synthetic bone-like material are inserted between the vertebrae, and metal rods and screws hold the vertebrae in place.
Recovery: Full recovery takes 3–6 months, with patients gradually returning to physical activities.

Vertebral Body Tethering (VBT)

VBT is an innovative surgery that allows for spinal straightening while permitting growth.

How it works: Screws are placed along the spine’s curve, and a cord is tightened to straighten the spine, allowing for further growth over time.

Expanding or Growing Rods

For young children with rapidly worsening scoliosis, expanding rods may be used. These rods can be adjusted as the child grows, either manually or using a remote-controlled device.

Risks of Surgery

While scoliosis surgery has a high success rate, there are risks involved, including:

Infection
Nerve damage
Recurrent curvature at the surgery site

However, with modern surgical techniques and advanced technology, these risks have significantly decreased.

Lifestyle and Home Remedies

While scoliosis cannot be corrected through lifestyle changes, certain practices can promote overall well-being:

Exercise: Activities like swimming or yoga can improve posture and back strength.
Diet: A balanced diet rich in calcium and vitamin D supports bone health.
Physical therapy: Helps ease pain, strengthen muscles, and improve posture.

Preparing for Your Appointment

If scoliosis is suspected, a specialist such as a pediatric orthopaedic surgeon will perform a comprehensive evaluation.

What to Bring to Your Appointment

Before your appointment, prepare the following:

A list of your child’s symptoms and how long they’ve been occurring.
Information about any family history of scoliosis or spinal conditions.
Questions you want to ask your healthcare provider.

Questions Your Specialist May Ask

During the consultation, your specialist may ask questions to assess the condition further, such as:

Is your child experiencing any pain or difficulty breathing?
Has your child’s growth been unusually rapid in recent months?
Does anyone in your family have a history of scoliosis or related spinal conditions?

At Subang Jaya Medical Centre (SJMC), our dedicated team of specialists provides comprehensive scoliosis care, from precise diagnosis to advanced treatment options. If you suspect scoliosis in your child, reach out to our experts for personalised and compassionate guidanceWhile surgery is often recommended for severe scoliosis, non-surgical alternatives like bracing and physical therapy may be considered in specific cases where the curve is stable or the patient is nearing skeletal maturity.While surgery is often recommended for severe scoliosis, non-surgical alternatives like bracing and physical therapy may be considered in specific cases where the curve is stable or the patient is nearing skeletal maturity.

FAQs About Scoliosis Diagnosis and Treatment

Yes, scoliosis can often be identified through physical and neurological exams. However, X-rays or MRIs are needed to measure the severity and confirm the diagnosis.

Most patients can return to physical activities, including sports, within 3–6 months after scoliosis surgery, depending on the procedure and individual recovery progress.

No, braces cannot reverse scoliosis, but they are effective in preventing the spinal curve from worsening, especially in children who are still growing.

Low-dose X-ray imaging is considered the safest method for diagnosing and monitoring scoliosis in children, as it minimises radiation exposure.

Specialists consider several factors, including the size of the spinal curve, the child’s age and growth stage, and the likelihood of the curve worsening. Bracing is typically recommended for moderate curves in growing children, while surgery is advised for severe or rapidly progressing curves.

Yes, there are two main types of braces for scoliosis:

Day Braces: Worn throughout the day and designed to be discreet under clothing.
Night Braces: Worn only at night and suitable for specific scoliosis types.

Both types aim to prevent the spinal curve from worsening during growth.

Yes, scoliosis treatment, whether through bracing, physical therapy, or surgery, can improve posture, reduce discomfort, and enhance overall quality of life by preventing further curve progression and addressing related symptoms.

While surgery is often recommended for severe scoliosis, non-surgical alternatives like bracing and physical therapy may be considered in specific cases where the curve is stable or the patient is nearing skeletal maturity.

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