Pediatric Spine Expert James Policy, MD, Answers Five Key Questions About Scoliosis

Dr. Policy with scoliosis patient

Scoliosis is more common than many people realize: Roughly 1 in 100 kids and teens develop adolescent idiopathic scoliosis, the most common type of scoliosis, before or during puberty.

Getting diagnosed with scoliosis can be scary for kids and their families, but with timely diagnosis and the right treatment, scoliosis doesn’t have to change the trajectory of a child’s life.

In honor of National Scoliosis Awareness Month in June Stanford Children’s Health pediatric orthopedic surgeon James Policy, who specializes in treating kids and teens with scoliosis, answers key questions about the condition.

Dr. Policy is part of a team of specialists providing care close to home in the East Bay as part of the John Muir Health partnership with Stanford Children’s Health.

What is scoliosis?

The spine is usually straight, but a child with scoliosis has a spine that curves, so it looks more like an S or a C. More than 80% of scoliosis cases are idiopathic, which means we don’t know what caused them. These cases are most common in preteen and teenage girls. A less common type of scoliosis, neuromuscular scoliosis, develops alongside another condition, such as cerebral palsy, spina bifida, or muscular dystrophy.

How is scoliosis diagnosed?

Scoliosis usually doesn’t cause back pain, and many parents and kids don’t notice it until it is detected during a school screening or by a child’s pediatrician during a routine checkup.

How is scoliosis treated?

No two spinal curves are identical, so no two scoliosis treatment plans are identical. Treatment options depend on many factors, including your child’s medical history and age, what type of scoliosis your child has, and how far the curve has progressed. Many children with mild spinal curves don’t need treatment at all, and we instead monitor their spine’s curve over time. For children who do need treatment, most can see significant improvement from physical therapy and wearing a brace or a cast. A small percentage of children with scoliosis need surgery.

What should parents look for when deciding where to have their child treated for scoliosis?  

A big concern for many parents is radiation exposure during treatment. Many kids with scoliosis need 20 or more x-rays during their treatment to track how their spinal curve is progressing. At Stanford Children’s Health, we offer the EOS low-dose imaging system, which not only generates 3-D images that make it easier to diagnose and track scoliosis but also delivers 50 times less radiation than a standard x-ray. It’s also important to consider the array of treatment options offered at a given center. For example, we offer Schroth physical therapy, and if your child needs a brace, we have orthotists—experts in making and fitting braces—in our clinics to save you time and make sure your child gets the best-fitting brace.

What will the future be like for my child with scoliosis?

Fortunately, if it can be kept in the mild-to-moderate range, scoliosis does not have any long-term impacts on a child’s life—except for inspiring some to go into medicine! Patients with scoliosis go on to live active, pain-free lives and can play sports and participate in other physical activities during treatment and in the future.

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