Ask The Expert: Scoliosis

by HSS on the Move
7.2 blog

In honor of Scoliosis Awareness Month, Hospital for Special Surgery partnered with Curvy Girls Scoliosis to host our first-ever scoliosis Facebook chat, titled “Life with Scoliosis: Diagnosis and Treatment.” Thank you to all who participated! Below is an excerpt from the chat, with answers provided by Dr. Roger Widmann, Pediatric Orthopedic Surgeon and Dr. Lisa Ipp, Pediatrician.

The information provided in this chat is for informational and educational purposes, and doesn’t constitute medical or health advice for any individual problem. Please consult with your health care providers for any health problem and/or prior to starting any new exercise regimen and/or medication or changing or discontinuing any medication you have been prescribed. This chat is not intended to create a physician-patient relationship, or any other duty, between you and any member of HSS’ medical team.

Q1: I understand that goal of bracing is to keep the curve from progressing. In your experience, what percentage of patients experienced a reduction of their curve through bracing?

A: The most recent longitudinal study indicates 75% of patients will demonstrate decreased progression of their curves, but bracing does not correct existing curves.

Q2: I’ve recently learned of an exercise program called the Schroth Method. What do you know about its effectiveness? Is there an age beyond which it does not benefit?

A: The Schroth Method is a physical therapy program for patients with scoliosis. There are no good longitudinal studies to confirm it’s effectiveness at this time. At this point, the most proven treatment for stalling the progression of scoliosis curves is compliant bracing, and this is always in consultation with a spine surgeon.

Q3: Are there any studies on the emotional toll the surgery or bracing causes? We have seen an increase in discussions around home schooling or cyber schooling kids due to the physical pain of sitting post surgery and the emotional toll. Many moms described post-traumatic stress and depression issues.

A: The psychological consequences of having scoliosis and wearing a brace are very individual, but overall, there is little evidence to suggest that adolescents have any long-term psychosocial problems due to the condition or treatment. Here is a very interesting YouTube video of how one of our patients used her scoliosis diagnosis as a teaching opportunity for her friends and fourth grade classmates: http://www.youtube.com/watch?v=dlVXHVk-fIQ.

Q4:  Why is there no recommendation by SRS or AAOS for the number of hours out of brace for an out-of-brace xray? It is my understanding that it is strictly doctor preference. Wouldn’t zero hours out of brace show a different result than 24 hours out of brace?

A: That is correct; this is, at this point, at the discretion of the treating physician. There are numerous variables taken into consideration when deciding on what is best for each patient.

Q5: Is it true that having scoliosis surgery would not correct 100% of the curve you have?

A: It depends on the patient. Usually there is excellent correction (60-80%); however the goal is not always to achieve a zero degree curve but to prevent the curve from getting worse which would be the case without surgery.

Q6: What is surgery like now for teens- i.e., length of hospital stay, recovery, post-surgery cast or brace?

A: The average length of stay is 4-6 days, and return to sports now much shorter time frame, about 3-4 months vs. 6 months. There is usually no post surgery brace or cast.

Click here to learn more facts about scoliosis through an infographic on Adolescent Idiopathic Scoliosis, presented by the HSS Lerner Children’s Pavilion.

Dr. Lisa Ipp is Chief of Pediatrics and a  Pediatrician at Hospital for Special Surgery. She is also affiliated with the American Academy of Pediatrics and the Society for Adolescent Medicine.

Dr. Roger Widmann has been a member of the Pediatric Orthopedic Surgery Service at Hospital for Special Surgery since 1995 and the Chief of the Pediatric Orthopedic Surgery Service since 2004. He s also a member of the Scoliosis Service at Hospital for Special Surgery.

Topics: Ask the Expert, Baseball, Basketball, Featured, Orthopedics, Pediatrics, Rehabilitation and Fitness
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The information provided in this blog by HSS and our affiliated physicians is for general informational and educational purposes, and should not be considered medical advice for any individual problem you may have. This information is not a substitute for the professional judgment of a qualified health care provider who is familiar with the unique facts about your condition and medical history. You should always consult your health care provider prior to starting any new treatment, or terminating or changing any ongoing treatment. Every post on this blog is the opinion of the author and may not reflect the official position of HSS. Please contact us if we can be helpful in answering any questions or to arrange for a visit or consult.

Comments

Deirdre says:

I think I am the first adult in the world to get the new
Magec rod!!
I am in stage 1 respitory failure and this was
My only hope. It worked!
Done by mr pat kiely in Dublin Ireland.

Deirdre says:

Can congenital scoliosis with restricted lungs of
Only 30%.can the lungs be ok after rods?

HSS on the Move says:

Hi Deirdre, thanks for reaching out. Dr. Matthew Cunningham, orthopedic surgeon, says “Yes. Decreases in PFTs tend to correlate with surgeries that need to break ribs or otherwise damage the chest wall. Using the newer rods and screws available today, it is infrequent to need to use chest wall damaging procedures (such as a thoracotomy or thoracoplasty) to get the spine to correct as needed to treat the deformity – so, I would predict that the PFTs would not have to get worse following surgery done today. Furthermore, when the spine gets straightened, the chest wall is also reshaped, typically to look and function more normally – which may allow the lungs to work more efficiently and improve the measured PFTs. As to the question of how much improvement in PFTs to expect, it is a bit harder to tell, and is influenced on how bad the spine deformity got at what age of the patient – if it was severe when they were young (3-9 years old), then the lungs may have developed incorrectly, and less PFT improvement would be expected, but if severe deformity started later (10 or older) then we’d expect the lungs to be much less affected, and increases would be expected to be bigger.” If you wish to receive care at HSS, please contact our Physician Referral Service at 877-606-1555 for further assistance.

Diana says:

Hi i have an ask the expert question, i dont know if im supposed to ask it here or in the contact page, i sent it in the contact page, do i need to do it over here?

HSS on the Move says:

Hi Diana, please contact us at socialmediacontact@hss.edu so we can further assist you.

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