Hospital of Wisconsin is one of two pediatric hospitals in the
nation to offer the EOS scanner for scoliosis patients.
In the past,
some children with scoliosis faced a difficult surgery with up to a
year of inactivity, but today that time has been reduced thanks to
advancement in surgery and other treatments.
The rigid back
brace to try and correct the spinal curvature is still used in some
circumstances, but a new treatment involving stretching and breathing
has been shown to be quite effective.
Scoliosis is a
medical condition that causes an abnormal "S" or
"C" curvature of the spine. People of all ages can be
affected by scoliosis, but the most common type is idiopathic
scoliosis, occurring in children age 10 to 12 and the early teens.
Girls are more likely than boys to have this type and there is no
known cause for it. Two other common causes of scoliosis are:
Congenital — present at birth; and Neuromuscular — due to diseases
such as cerebral palsy, muscular dystrophy or spina bifida.
Institutes of Health reports that about 2 percent of people have some
form of scoliosis. Depending on the seriousness of the spinal curve,
scoliosis may not be noticeable at all or it may cause pain and
discomfort and require treatment or even surgery.
scoliosis is mild we usually just observe it. When there is a moderate
curve, we can treat it with a brace — a plastic shell that squeezes
the back and forces the spine to grow straighter. This works 80
percent of the time," according to Dr. Brian Black, a children’s
orthopedic surgeon with Midwest Orthopedic Specialty Hospital in
Franklin. "The brace won’t resolve the scoliosis, but it will
prevent it from getting worse," he explains.
If there is a
severe curve, however, surgery is often warranted, and current
surgical techniques have improved. "Surgery involves a spinal
fusion with placement of a rod that straightens the spine. It used to
mean up to a year of inactivity, but now most kids return to full
activity within three to four months," Black says. He also
believes that surgery can be avoided in some children via a program of
aggressive physical therapy known as the Schroth method. This involves
stretching and breathing exercises repeated every day for an extended
period of time.
Some of Black’s
patients have achieved good results with the Schroth method. "It
is somewhat controversial here, but it is used extensively in Europe
and it enhances bracing and helps stop the curve. I have seen patients
do very well with it. In fact, some of my patients have gone on to
become excellent athletes," he says. Black often works with a
physical therapy center called Spinal Dynamics.
When a child has
scoliosis, physicians like to follow their growth and development
carefully, which means having spine X-rays at least every six months
until they have reached their full height. "This exposes children
to a lot of radiation," says Dr. John Thometz, director of
orthopedic surgery for Children’s Hospital of Wisconsin. CHW is one
of just two pediatric hospitals in the nation that invested in an EOS
low-dose radiation scanner that is used primarily on children with
"One of the
major benefits of using the EOS scanner is the significant decrease in
radiation dose. It is 10 times less than a regular X-ray and up to 89
percent less than a CT scan of the spine," says Thometz. A second
benefit is the 3-D view it offers. "Scoliosis is a three
dimensional deformity and X-rays only give us a two-dimensional view.
The EOS is like a large box that takes a three dimensional image of
the patient from top to bottom, giving us the full picture," he
looking for the causes of idiopathic scoliosis by studying genetics,
growth and changes in the spine. Currently, studies are under way to
determine how different treatments can help to straighten the spine or
keep curves from getting worse. "If we can identify scoliosis
earlier and force the spine to grow straight, it may prevent surgery
down the road," Thometz says.