How is early onset scoliosis treated?
There are a variety of different treatment options your provider may recommend based on your child's condition. These treatments include casting and bracing, halo traction, short fusions and magnetic rod treatment.
Casting and bracing
Providers are increasing their use of casting to treat early onset scoliosis. In many cases casting can offer a way of straightening your child's spine non-invasively over time. A cast is used to guide growth of the curved spine into a straight spine. For some children, casting is used as a means to prevent or delay progression of scoliosis.
A pediatric spine specialist will apply your child's cast in a procedure center or operating room. Our pediatric specialists will place your child under anesthesia but will not make an incision during the application. The cast typically needs to be changed every two to four months. The procedure is not painful and no pain medicine is needed following cast application. Children can be active and play normally while wearing spine casts.
Bracing is also used for management of early onset scoliosis. Providers often use bracing after your child's spine has been straightened with casting or as an alternative in kids who are too old for casting or families who do not want their child in a cast.
Halo gravity traction
In severe cases of early onset scoliosis, your child's doctor may recommend halo gravity traction to help reduce the curvature of your child's spine. Halo gravity traction uses a horseshoe-shaped ring that is secured to your child's skull with pins. This halo is used to straighten your child's spine by gently pulling the body. It can be used for severe early onset and severe adolescent scoliosis patients.
While it may sound like a painful treatment, most children respond very well to halo gravity traction. Many kids may have a headache for one to two days after the halo is applied and are treated with appropriate medications for pain relief. After the first couple days children generally have no pain with halo gravity traction, and many actually feel better with their spine stretched out than they did before traction was applied.
What's the procedure for applying halo gravity traction?
One of our orthopedic spine surgeons will apply the halo in an operating room. After one to two days, we will add weight using a novel spring-based system unique to Children's Colorado Spine Program.
Children are able to use a walker and a wheelchair to remain mobile while in traction (wearing the halo). Typically we will add weight in two to three pound increments until about half the child's body weight is achieved. In many cases, children can go home once they have reached their goal traction weight.
The amount of time your child will be in traction will depend on your child's unique case. Some children will move from traction to casting, spinal fusion or magnetic controlled growth rod treatment.
Short spinal fusions
Doctors may recommend a short spinal fusion for certain cases of congenital scoliosis. We typically recommend this for patients with a central area of the spine that was not formed properly, such as a single hemivertebra (malformation in the spine).
A short spinal fusion can control the spinal deformity, while permitting the bulk of the spine to grow normally. This surgery is similar to the surgery used for adolescent idiopathic scoliosis; however, it is performed over a smaller segment of the spine and uses smaller spinal screws and rods.
Magnetic controlled growth rod treatment
Magnetic controlled growth rod (MCGR) treatment is an advanced approach for treating kids with early onset scoliosis. This new technology uses a rod to lengthen your child's spine as they grow, without the emotional or physical discomfort of surgeries. This means your child would need fewer surgeries and less pain medication, and they would miss fewer school days as they grow.
What to expect when the magnetic controlled growth rod is placed
Before surgery, you will meet your child's surgeon and one of our spine nurses. They will explain more about your stay at Children's Colorado. This presurgery visit includes a tour, discussion about what it is like to be in the hospital, recovery information and the goals for discharge from the hospital.
Surgeons place the MCGR during an inpatient surgery. A pediatric anesthesiologist will help your child fall and stay asleep during the surgery. Your child will then stay in the hospital a few days following the surgery before they go home.
What to expect at your first rod expansion visit
After the initial surgery when rods are inserted into your child's back, patients and families will return to our outpatient clinic every two to four months for rod expansions.
At the rod expansion visit, your child gets into a comfortable position either on their stomach or side. Then, a pediatric spine specialist uses an external remote control to lengthen the rods from the outside of the skin. The external remote control causes the magnets in the rods to make the rods longer. Your doctor will decide how much to expand the rods on an individual basis.
Learn about 10-year-old Ryan Viano, our first patient to benefit from these new magnetically controlled rods.
The expansion is a quick outpatient visit
Rod expansion only takes a few minutes. Your child will usually watch TV or play a game on a tablet during the expansion. As the rods are expanded, your child may experience a tingling or odd feeling in their back, but most don’t describe the feeling of pain during the expansion.
After we expand your child's rods, your doctor will use ultrasound imaging to evaluate the length of the rod expansion. Then, you and your child can head home and return to normal life.
Benefits of the magnetic controlled growth rod
- Rod expansion is done at an outpatient visit
- The expansion only takes a few minutes
- No pain medication is needed, recovery or missing school/work after expansions
- Fewer X-rays
Why choose Children's Hospital Colorado for your child's early onset scoliosis?
At Children's Colorado, we have one of the largest early onset scoliosis programs in the region. Our pediatric specialists are core members of the Children's Spine Study Group and Scoliosis Research Society. We're also actively involved in cutting edge spine research and have numerous scientific publications on scoliosis.