We offer the most current treatments for children with scoliosis. When appropriate for your child, this includes investigative treatments. We perform surgeries to correct spinal deformities, and we also offer treatments that do not involve surgery.
Scoliosis Treatment Options
Young children whose spinal curves are between 20 degrees and 40 degrees may benefit from wearing a back brace to stop the curve from getting worse as they grow.
If your child begins treatment with a brace, they may wear it until they finish growing or the curve gets so large that they need surgery.
With this therapy, fitting the brace correctly is important. We have extensive experience in making braces to fit children of all sizes and ages. Read about braces and our other orthotics and prosthetics services.
Therapies such as massage, physical therapy, chiropractic manipulations, exercise programs and electric stimulation do not hurt the spine. But they have not been shown to correct scoliosis or prevent the progress of it.
Surgery for Scoliosis
Children with spinal curves that are greater than 50 degrees may need surgery. Our surgical team uses a number of operations to correct the curve and stabilize the spine.
Spinal instrumentation. Many forms of spinal instrumentation are used in scoliosis surgery. The classic Harrington instrumentation (red arrow) and more modern CD form (yellow arrow) are examples.
Spinal fusion
The most common operation for scoliosis is spinal fusion, which straightens your child’s spine by releasing some of the ligaments and joints around the spinal cord and attaching a metal rod to the bones in the back.
In a spinal fusion operation, the doctor makes a cut (incision) to reach your child’s spine. The doctor reaches the spine either from the back (posterior approach), or from the side (anterior approach).
The doctor puts hooks or screws in the bones of the spine, removes the joints between the bones and attaches the rod to the hooks or screws.
The doctor repositions your child’s spine so that it is straighter. Then the doctor tightens the screws or hooks to make sure they are firmly attached to the rod. Finally, the doctor places a bone graft along the spine to help the bones of the spine grow together.
Spinal fusion using thoracoscopy
It is possible to use a minimally invasive procedure called thoracoscopy to perform a spinal fusion. Putting rods in to straighten the spine using this technique is also possible, but this is not done very often. Only a very limited number of children have curves that are in the correct shape and location to use this technique effectively.
In this operation, the doctor uses special equipment to view the operation on a monitor like a television. Through small cuts (incisions) in your child’s chest, the doctor inserts tiny tools attached to the end of long rods.
These tools help the doctor attach a metal rod to the bones of the spine. With this operation, the doctor does not need to make a large cut.
We usually consider this operation only for children with moderately large curves in the chest portion of their spines. The surgery is best done by medical center staff with extensive experience in thoracoscopic work. At Seattle Children’s, we have performed more than 50 thoracoscopic procedures for spinal deformities.
Growing spine system
This operation may help very young children whose spines are still growing and who are not helped by treatment with a back brace.
The operation is called “growing spine system” because it uses spine-supporting metal rods that can be lengthened as your child grows. As in spinal fusion, the doctor attaches a rod to the bones in your child's spine. Unlike spinal fusion, the doctor does not remove the joints between the bones and does not fuse the spine.
With this treatment, your child needs surgery about every six months to lengthen the rod as they grow.
In addition to more conventional types of growing systems, we are one of seven centers in the United States involved in the development of a new technology called vertical expandable prosthetic titanium rib (VEPTR).
VEPTR allows us to treat spine conditions in very young children who have fused ribs, congenital scoliosis and severe chest wall deformities.