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Old 23-07-2015, 09:20 PM
mia mia is offline
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Smile What should I do for my son?

I have a 16 year old son whose x-rays revealed a curve of less than 10 degrees at the end of last year. I have had spinal surgery for a severe curve (had gone from 63 degrees pre-menopause to 79 degrees right thoracic curve once I was 57 years old - it was a 63 degree adolescent idiopathic scoliosis, untreated until I turned 58 years old) so the curve is now a lot less.

It is now 6 months after my son's first x-rays and I can see that his right shoulder is developing a bit of a hump (not a hump - just uneven when looking down the centre of his spine and he is standing) and he looks a bit rotated and awkward, but it is still barely detectable. I doubt that the curve would be more than 10 or 15 degrees now, but there are visible changes to a knowledgeable person within these 6 months. I think he still has a fair bit of growing to do and the curve is quite high in the thoracic region (about the same area as mine started in I think) so any curve there is more easily detectable to me....he could have another 12 inches (sorry about imperial measurements) to grow in height and is still skinny and boy-looking, and I think about 2 years into his puberty at this stage ,maybe more. He doesn't play sport but he is very involved in vocal performance and drama (Justin Bieber or One Direction youthful looking young guy style image and body shape), and quite successful. I am pretty sure he wouldn't wear a brace.

I know a physiotherapist who has treated a few boys prior to their corrective surgery using machines to strengthen the rest of their body (and to try to stop the increasing curve in his mind). He claims to have stopped lower back compensatory curves developing in these boys. The machines are very intensive and my son still has a low body mass for his age (typical of our family who are late to reach puberty).

I don't want to neglect seeking treatment for him and so indirectly leave him with a similar problem to what I had to face adult life with (my parents were against surgery and were told I didn't need it!), nor do I want to put him through a whole lot of unpleasant and expensive intervention that may not achieve anything.

1. At what stage of curve is surgical intervention necessary to prevent further curve and rotation?
2. Is heavy "remedial" exercise (whether it does anything for the curve or not), likely to be harmful to the development of a 16 year old skinny teen?
3. Where should my starting point be with monitoring my son.....a scoliosis clinic at a public hospital? A specialist? Or just 6 monthly x-rays and my GP? With my personal experience and awareness of the genetic possibility for my son's curve, I am probably over-worrying and over-observing.
4. My son complains periodically of severe back pain and neck pain. I remember feeling this as a teenager, carrying my huge schoolbag full of heavy textbooks to and from school each day. Most of his complaints seem to be when he doesn't want to go to school for a test or similar......and he is so good at drama that I honestly can't tell whether he is really experiencing the pain or not. He has had some severe muscle spasm in his neck over the past few years where he has been unable to move it for some hours and I know that is genuine....not sure about the extent of the other though.
5.I have 7 kids and a few of them went through a stage of "looking awkward" around the shoulders at puberty, but none have diagnosed scoliosis other than very mild and not needing treatment in 1 of them. I put these "awkward" ones into ballet classes for several years, with a teacher who had scoliosis herself and it seemed that once they were standing properly, the uneven-ness was outgrown. I don't think my son would want to do ballet but do you think something like that, which is gentle and encourages movement and good posture, might be all he needs at this stage?

Sorry this is so long. I hope I have given you enough information for you to suggest the starting point for me with my son over this and to answer my other questions.

Many thanks.

Last edited by mia; 23-07-2015 at 09:23 PM. Reason: didn't want to say too much about puberty
  #2  
Old 26-07-2015, 04:42 PM
Dr Scoliosis Dr Scoliosis is offline
 
Join Date: Apr 2009
Posts: 187
Default Re: What should I do for my son?

Dear Mia,

Thank you for your questions. In reply:

1. Surgery is rarely needed for scoliosis. In general, treatment, whether surgery or bracing, is considered when the cosmetic appearance is, or is likely to become unacceptable. Bracing can stop a curve worsening (80% chance of being successful). Bracing is generally indicated for someone who has a curve between 20 and 40 degrees and has at least 18 months of growth left. Surgery is reserved for those where bracing is not an option.

2. In people with idiopathic scoliosis, the back is not weak. Exercise should be encouraged and there are no limitations to sport. Back ache is common after activities and usually settles quickly.

3. Regarding monitoring, it is recommended that your son see his GP who can arrange x rays. The next step would be the scoliosis clinic at your local children's hospital or specialist rooms. Given that your son appears to have considerable growth left, I would not delay. As can be seen above, there is a narrow window where bracing is possible and with the adolescent growth spurt, a curve may quickly go beyond that point.

4. Almost all people with scoliosis get back pain. Typically, it is an ache, around the middle of the curve. It is worse at the end of the day and after activities. It improves with rest, massage and simple analgesia like paracetamol. If pain is severe, review by your GP is recommended.

5. Ballet and other forms of dance or sport are useful at many levels. However, none will prevent the progression of a structural scoliosis. Many teenagers develop postural deformities - slumping, "round back" and the like, during growth. These are innocent and tend to resolve with time. Stretches and core exercises can help improve these postural changes.

I hope this is helpful. Many of your questions are dealt with in more detail on the website.

Dr S
 

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