Two of the remarkable Kid Captains featured at Iowa football games this season have undergone surgery for scoliosis at University of Iowa Children's Hospital.
Scoliosis is not a disease. It is an abnormal side-to-side curve in the spine that affects 2 percent of women and 0.5 percent of men. Stuart Weinstein, MD, pediatric orthopaedic surgeon at UI Children's Hospital, talks about scoliosis:
What causes scoliosis?
For the majority of children with scoliosis, there is no known cause. We're getting more and more information that it probably is a genetic disorder, but for the moment, we attribute it to unknown causes. However, there are many conditions that exist where scoliosis is associated.
Can scoliosis be inherited from a parent?
As more and more information comes to the front, we are learning that probably the most common variety of scoliosis—what we call ideopathic scoliosis—is probably going to be a genetic or an inherited condition.
What are the symptoms of scoliosis parents should be aware of?
Most patients with scoliosis don't have any symptoms. The children we see at University of Iowa are usually referred because a deformity is picked up on school screenings or sports examinations. Parents might be a bit suspicious when children have waist asymmetry or shoulder asymmetry, or any apparent trunk asymmetry.
How is scoliosis diagnosed?
When children go for their school physicals or their sports physicals, the primary care physician should have the child bend over in what's called the Adam's Forward Bend Test, where the child bends forward with their hands together as if they're diving into a pool. The physician then can see the asymmetry of the chest or the waist much more apparent in that position.
What are treatment options for scoliosis?
Fortunately most children with scoliosis don't need any treatment, but for children with more severe curves, we're involved in a large, multi center study sponsored by the National Institute of Health to determine whether the standard treatment for scoliosis since the 40s—that's a brace—is really effective. For children with larger curves, surgery is usually warranted to correct the curvature.
How is scoliosis corrected surgically?
The surgery is very complicated. It involves inserting rods that are attached to the spine via hooks and screws. We untwist the scoliosis as much as possible and straighten out the curvature, and fuse the spine in that position to allow it to remain that way for the remainder of the child's life.
Two of this year's Kid Captains had surgery to correct their scoliosis at UI Children's Hospital—one traveling from New York. What makes your approach so successful?
We're very fortunate at The University of Iowa to have a wonderful team of physicians—anesthesiologists, pediatricians, and intensivists—help deliver what I consider first rate care for children with scoliosis.
How many scoliosis surgeries do you do each year?
I do two to four surgeries on children every week.
When a child recovers from surgery for scoliosis, can they resume normal activities, or are there limitations?
The average youngster who has scoliosis and has surgery—the recovery time is usually about five days in the hospital, and then its six months till the healing occurs. Once the healing has occurred, the majority of children can return to full, unrestricted activities.
Will children with scoliosis experience any related problems as adults?
We've had the opportunity to follow children their entire lifetime and have done follow up studies for more than 50 years because of the population base at the University. So far patients who have had scoliosis surgery as youngsters have led normal, productive, healthy lives. |
