It’s back-to-school physical season, and the right time to remind parents that children between the ages of 10 and 14 should be screened for scoliosis.
During a routine exam, pediatricians should look for classic signs like asymmetry in the shoulders, chest wall or hips, or even a visible curve in the spine.
Scoliosis affects up to 3-4% of the population. It is more common in girls than boys, and tends to run in families.
Early diagnosis is important as it can lead to the best course of therapy. And with newer research, there are also new options that may help some children avoid bracing or more invasive surgical treatment, said Endeavor Health pediatric orthopedic surgeon David Roberts, MD.
How early detection helps avoid bracing and surgery
“Traditionally the goal of screening has been to identify children for brace treatment — moderate curves (25-40 degrees) in children who are still growing. These curves are at risk of progression to more severe scoliosis, which may need surgery,” said Dr. Roberts.
“Early identification and treatment with a brace can avoid surgery in most cases. Mild curves are not treated actively with bracing, only watchful waiting to see if the curve worsens and needs bracing at a later time,” he added.
Calcium and vitamin D supplementation
Recently, research has shown the real benefits of calcium and vitamin D supplementation for children with scoliosis.
“We’ve always suspected that there was a connection between scoliosis and low vitamin D, and now the science has shown the value of vitamin supplementation,” said Dr. Roberts. “We know that giving vitamin D and calcium supplementation, especially when started early enough, can help some younger children avoid curve progression and reduce the chance of needing a brace altogether.”
Over the years, specialists have noticed that fewer kids get worse, and some kids even get better, with regular use of calcium and vitamin D supplements while under observation for scoliosis. “It’s great to now have better evidence supporting this,” said Dr. Roberts.
If there is a history of vitamin D deficiency in the family, or if your child has experienced broken bones without a traumatic accident or other obvious cause, screening for vitamin D could be helpful.
“It’s important to start the supplementation early as a preventative, with potential benefit for children at risk of developing scoliosis or other bone health related conditions,” he said.
“It’s exciting to think that we may be able to reduce the need for bracing for many children going forward with this simple, low-cost intervention,” added Dr. Roberts.
What to expect if a screening is abnormal
When a scoliosis screening exam is abnormal, X-rays are done to confirm the diagnosis and evaluate the curve. A referral to a pediatric orthopedic specialist with scoliosis experience is typically the next step.
Parents can talk to their pediatricians during upcoming back-to-school checkups to ensure that their children are screened for scoliosis.
Endeavor Health Orthopaedic & Spine Institute at Skokie Hospital has a specialized low-dose X-ray, which is preferable for children undergoing repeated X-rays, said Dr. Roberts.
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