Watch Your Child's Back
Scoliosis, being one of the most prevalent back deformities affecting growing children, in some cases with potentially serious consequences, stirs notable anxiety among patients and their families. Parents can easily check for any signs of scoliosis in their children, and to start appropriate treatment in a timely manner.
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Scoliosis was originally a Greek word meaning curved or bent. Today it is a word used to describe the most common type of spinal curvature. Scoliosis is simply a descriptive term, like headache, and not a precise diagnosis.
When a scoliosis develops, the spine bends sideways and rotates along its vertical axis. These changes have cosmetic and physiological effects with long-term health consequences if the curvature worsens and is left untreated.
Heavy School Bags Do Not Cause Scoliosis
Dr Liu King-lok, Specialist in Orthopaedics and Traumatology at Matilda International Hospital, sees many children with a range of spinal problems, particularly scoliosis. Dr Liu said, “Many parents I have seen think that scoliosis can be caused by adopting a poor posture, unequal leg-length, carrying heavy school bags on the back, practising the violin, playing various sports, and even back injury, however, all these factors do not lead to scoliosis,” said Dr Liu. According to him, the causes for 80-85% of all scoliosis cases are usually unknown. “Scoliosis can occur in toddlers and young children, but the majority of cases occur from age 10 to 15. Boys and girls are equally affected by small curves, but girls are eight times more likely to develop progressive curves. According to recent research, about one in three children whose parents have scoliosis will develop scoliosis. Scoliosis is considered a partially genetic condition. However, exactly which genes cause scoliosis is inconclusive.”
Usually Painless
Dr Liu also said that it is a common misconception that scoliosis causes significant back pain and functional disability. “In fact, mild to moderate scoliosis typically does not cause back pain and will not cause compression onto the nerves or the heart and lung. Only very severe scoliosis curves will cause heart and lung problems,” he said.
Treatments Will Depend on the Curvature
According to Dr Liu, the majority patients he sees have mild curves at 10 to 20 degrees, and this will not cause any problems, and no treatment is required if the bone structure of the child is mature. For growing children, a regular check-up every four to six months is recommended to catch any curve progression.
He continued, for growing children with moderate curvatures that are between 20 to 45 degrees, a well-fitted and diligently-worn corrective brace should suffice. “This method will not completely treat scoliosis, but it can significantly slow down or prevent curve progression,” Dr Liu said.
For a handful of children with severe curves of over 45 degrees, surgery is recommended to correct the curve. “Nowadays, the precision and safety of the surgery is aided by the advancement in surgical techniques, such as computer navigation and the use of intra-operative monitoring,” Dr Liu said.
“Apart from the child’s general wellbeing, scoliosis can affect some patients psychologically, “said Dr Liu, “I have a 22 year old patient. When I first saw him, he was 1.63m tall. He recounted a time when he went for a job interview, and the interviewee thought that he lacked confidence as he could not stand tall. A surgery to correct his bent spine from 126 degree to 46 degree restored his height to 1.73m. The young patient was very happy, and regained the confidence that was lost over the years. ”
Simple Back Checks Parents Can Do At Home
Although the majority of scoliosis cases are not severe, parents should be aware of any anatomical changes in the growing child. Dr Liu has tips for parents to perform simple checks. “First, take off the child’s top, and have the child stand with feet together. Observe from behind the child, and look out for signs such as uneven shoulders levels and protruding shoulder blades. Pay attention to the child’s back, the asymmetry in the waist line contour, or a tilted pelvis. Also, ask the child to bend forward, and check if the ribcage protrudes significantly,” he said. “If any variation from the norm is seen, consult a specialist as early as possible for closer monitoring and if necessary, further investigations by X-rays,” Dr Liu said.
