Source: Indys Child Parenting Magazine

Casting a New Light on Scoliosis
Breakthrough Treatment for Spine Curvature Offers Hope to Young Patients

by Shyam Kishan, M.D.

December 01, 2010

Scoliosis rarely registers on a parent’s list of worries before a child is born. But this abnormal, side-to-side curvature of the spine does occur in infants and very young children – and early detection is key to achieving the best possible outcome.

When scoliosis occurs in children under three years of age, it is called infantile, or early onset, scoliosis. Left untreated, this condition can be debilitating and even life-threatening, as the twisting spine puts pressure on the growing heart and lungs. Fortunately, help is available – and one breakthrough technique is changing the way that doctors are treating their youngest patients.

Straight talk about a serious condition

There is no known cause for early onset scoliosis. The condition is rare, but there are telltale signs for parents, pediatricians and primary care physicians to look for during the early months and years of a child’s life. These include asymmetry in the shoulders and back, or one side protruding as the child bends forward.

If scoliosis is suspected, a child should immediately be referred to an orthopedic surgeon. Once a diagnosis is made, a treatment plan will be developed taking the patient’s unique situation into consideration.

For decades, parents of infants and young children diagnosed with early onset scoliosis have had two primary treatment options to consider. The first is the brace, which offers only limited success, in large part due to compliance issues. Because a brace can be taken on and off, parents often face huge challenges in keeping their children in them. The second is surgery, which is often a less-than-ideal option as most operations result in a shortened spine and poorly developed chest and lungs.

Now, another alternative is offering patients new hope for treatment – and even a cure.

New option now available at Riley

Riley Hospital for Children recently became the first hospital in Indiana to offer a breakthrough treatment known as scoliosis casting. In this technique, a child is placed under general anesthesia so that the body is completely relaxed. After manipulating the spine into a better position, physicians carefully apply a plaster body cast around the patient’s chest and abdomen.

This method relies on the growth potential of the young spine to correct the abnormal curvature – with the cast guiding the spine into normal alignment. The casts are changed every three to six months, gradually straightening the spine completely in many cases. Scoliosis casting results in a complete correction for a significant number of patients, making surgery unnecessary. Even in cases where the results are less dramatic, the cast treatment works well in delaying surgery to a time when children are older, allowing their lungs and bodies to develop.

Children are remarkably resilient, and they adapt surprisingly well to this treatment. They can sleep, bathe, run and play in their casts. In other words, they can be kids.

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Dr. Shyam Kishan is a pediatric orthopedic and scoliosis surgeon at Riley Hospital for Children.