Scoliosis In Children

WHAT YOU SHOULD KNOW:

• Scoliosis (sko-le-O-sis) is an abnormal curving of the spine to the side. Normally, the spine is made up of many back bones that are like blocks placed on top of each other. It should be straight when seen from the back and a mirror-image letter 'S' from the side. With scoliosis, the bones are not properly placed on top of the other causing the spine to curve sideways. The abnormal curving in the spine may limit chest movement and cause lung or heart problems. In most cases, the cause of scoliosis is unknown. Your child may have a greater chance of having scoliosis if someone in your family also had it. A birth defect on his spine or other health conditions affecting the muscles or bones may cause scoliosis.
  
  
• Your child may lean to one side with his shoulder or waist lower on one side than the other. His shoulder blade, ribs, or hip may stick out more on one side than the other. Other signs include a sunken chest, rounded shoulders, and swayback. A detailed health history of your child and physical exam may help diagnose scoliosis. Tests to look at the spine, such as x-rays, computerized tomography (CT) scan, or magnetic resonance imaging (MRI) may also be done. Treatment of scoliosis in children aims to correct or control the curving of the spine and prevent further problems. This may include watchful waiting, using a cast or back brace, or surgery. With proper treatment and care, your child's scoliosis may be controlled and further problems prevented. Ask your caregiver for more information about these tests and treatments.

CARE AGREEMENT:

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child.

RISKS:

Treatment for scoliosis may cause unpleasant side effects. Wearing a back brace may cause great discomfort to your child. Surgery may cause him to bleed too much, get an infection, or have a spinal cord injury. If left untreated, the spine may continue to curve sideways. There may not be enough room in your child's chest for his heart and lungs to work well. His spinal cord and nerves may get pressed on and lead to problems or changes in organ function. Diagnosing and treating scoliosis as soon as possible is very important. Call your child's caregiver if you are worried or have concerns about your child's condition, treatment, or care.

WHILE YOU ARE HERE:

Informed consent:

A consent form is a legal document that explains the tests, treatments, or procedures that your child may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your child's medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done to your child. Make sure all of your questions are answered.

Emotional support:

Stay with your child for comfort and support as often as possible while he is in the hospital. Ask another family member or someone close to the family to stay with your child when you cannot be there. Bring items from home that will comfort your child, such as a favorite blanket or toy.

Medicines:

Your child may have any of the following:

• Antibiotics: This medicine is given to help prevent or treat an infection caused by bacteria.
  
  
• Pain medicine: Your child may need medicine to take away or decrease pain. Know how often your child should get the medicine and how much. Watch for signs of pain in your child. Tell caregivers if his pain continues or gets worse. To prevent falls, stay with your child to help him get out of bed.

Tests:

• 12 Lead EKG: This test helps caregivers see your child's heart activity. It helps caregivers look for changes or problems in different areas of the heart. Sticky pads are placed on your child's chest, arms, and legs. Each pad has a wire that is hooked to a machine or TV-like screen. This machine shows a tracing of your child's heartbeat. This test takes about five to ten minutes. Your child must lie very still during the test.
  
  
• Blood tests: Your child may need blood tests to give caregivers information about how his body is working. The blood may be taken from your child's arm, hand, finger, foot, heel, or IV.
  
  
• Imaging tests:
  
  
  • CT scan: This test is also called a CAT scan. An x-ray and computer are used to take pictures of your child's body. Your child may be given dye, also called contrast, before the test. Tell the caregiver if your child is allergic to dye, iodine, or seafood.
    
    
  • Echocardiogram: This test is also called an echo. Sound waves are used to show pictures of the size and shape of your child's heart. The echo can also show how well the heart is pumping and how well blood flows through it. Your child will lie down during the test. Caregivers will squirt clear gel onto your child's chest to help the echo probe move easily. The echo pictures are shown on a TV-like screen. The whooshing noise that you may hear is the sound of blood flowing through the heart. Caregivers may ask you to stay in the room with your child during this test.
    
    
  • MRI: An MRI uses a powerful magnet and radio waves to take pictures of the inside of your child's body. Caregivers may use the MRI to look at your child's brain, muscles, joints, bones, or blood vessels. Your child will need to lie still during his test. Never enter the MRI room with any metal objects. This can cause serious injury.
    
    
  • X-rays: Several x-ray pictures may be taken of your child's spine, including views taken from the back and sides. Your child's caregiver will carefully look at the x-rays to check the curve or shape of the spine. Other problems, such as broken, incomplete, or fused bones may also be seen. Your child's caregiver may also check if your child's bones are still growing.
  
  
• Pulmonary function tests:  Pulmonary function tests, also called PFT, help caregivers learn how well your child's lungs work. These tests may also help caregivers decide on the best treatment for your child. During the tests, your child will be asked to breathe into a mouthpiece connected to a machine. The machine measures how much air is breathed in and out over a certain amount of time. This helps caregivers to see how well your child's lungs are moving and working.
  
  
• Sleep studies: Your child may need to have sleep studies if he has severe scoliosis. Sleep studies can help caregivers see how your child's heart and breathing are doing during sleep. Sleep studies may monitor the oxygen levels in your child's body during sleep.

Treatment options:

• Surgery: Surgery may be done if the curve in the spine is very bad and a back brace does not help. Your child may have surgery to join bones together along the curve. Rods, screws, or wires may be put in the spine to make it straight.
  
  
• Non-invasive positive-pressure ventilation: This is also called NIPPV. A machine helps your child's lungs fill with air through a mask or a mouthpiece. The mask may be put over your child's nose and mouth. Extra oxygen may also be given to your child through the machine. This may be needed if your child develops a bad lung and heart problem due to scoliosis.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Scoliosis In Children (Inpatient Care)