Scoliosis

The Spine Program at Seattle Children’s treats all types of scoliosis in babies, children, teens and young adults. Ours is the largest pediatric spine center in the Pacific Northwest. We offer the most comprehensive care for your child, no matter how complex their condition is. It’s why other hospitals in the region refer their most complex pediatric patients to us.

• The experts you need are here
  • The Spine Program team includes doctors, surgeons, physician assistants (PAs) and nurse practitioners (NPs) from Orthopedics and Sports Medicine. More severe curves may be harder to correct and affect the spinal cord and lungs. In these cases, the team includes experts from Neurosciences and Pulmonary Medicine. They meet as a group to talk about patients’ needs and treatment plans.
  • We can successfully treat scoliosis in most children with methods other than surgery. Often, this means a back brace to keep a spinal curve from getting worse. Our onsite orthotists build and fit braces. They see your child at the same visit with your child’s doctor, PA or NP to coordinate your child’s care.
  • If your child needs surgery, our orthopedic spine surgeons are leaders in their field. They have more training and experience with children’s complex spine conditions than anyone else in the area. Spine surgery for children is all they do. Each is board certified.
  • Spine conditions can affect more than a child’s bones, muscles and joints. That’s why we connect you and your family with any expert your child may need across Seattle Children’s. For example, we may involve Adolescent Medicine, Rehabilitation Medicine, Rheumatology and Pain Medicine.
• Our approach to surgery increases comfort and reduces stress
  • Our new state-of-the-art operating rooms reduce stress and increase comfort for your child. The design lets you stay by your child’s side until they gently go to sleep before any spine surgery.
  • Before we recommend surgery, we look at your child as a whole person. Your child’s team will take many factors into account. These include the degree of their spinal curve, the effects on their health and how much more they will grow. We also consider what results you can expect from treatment.
  • When growing rods were developed in the early 2000s, Seattle Children’s was among the first to offer them for children with a spinal curve. The rods help correct your child’s curve and still let your child grow.
  • Seattle Children’s offers the MAGnetic Expansion Control (MAGEC) system. With this system, your child may need fewer surgeries for severe scoliosis. Instead of surgery every 6 months to lengthen their growing rods, your child comes for office visits. The surgeon lengthens the rods using a remote control.
  • Our surgeons were among the first to use vertebral body tethering. This treatment can be used along with or instead of spinal fusion (making bones grow together into 1 bone). It can let children keep more movement in their spine.
  • We have the technology and skills to use 3D imaging to guide your child’s surgery, if needed. This helps us place hardware, such as rods and screws, with precision. It also lets us see in real time the changes we make to your child’s spine. Based on your child’s needs, we may use X-rays or CT (computed tomography).
  • We have a dedicated spine anesthesia team. They specialize in keeping children safe and comfortable during spine surgery.
  • Neuromonitoring helps us prevent a spinal cord injury during surgery. Our surgical spinal cord monitoring team leads the country in new ways to make back surgery safer.
• Care from birth through young adulthood
  • We specialize in caring for kids. This means our experts have the knowledge, training and skills to treat the youngest patients through young adults. We have treated many babies with infantile scoliosis and young children with early-onset scoliosis.
  • Babies, children and teens are still developing. When we evaluate your child’s condition, design their treatment and provide their care, we carefully consider their growth. We think about how growth may affect your child’s spine over time. We also consider how their spine may affect the rest of their development and health.
  • If your child needs imaging that uses radiation, we use the lowest amount possible (PDF) to make the best image. We have a low-dose radiation X-ray machine, called the EOS. It makes safer full-body images. We also have the largest group of board-certified pediatric radiologists in the Northwest.
• Support for your whole family
  • We know it can be stressful to have a child with a spinal condition and to find the treatment they need. Everyone at Seattle Children’s works to make your experience here as easy as we can on your whole family.
  • Your child’s team does more than plan and provide care for your child. We also make sure you and your child understand your child’s condition and treatment options.
  • Care is easier for you because your child’s Spine Program team will include experts from Orthopedics, Neurosciences and Pulmonary Medicine as needed. They work closely with each other and with other programs and clinics your child may need. For example, we often work with the Neuromuscular Program for muscular dystrophy. If your child has cerebral palsy, we work with the Ortho Rehab Clinic.
  • Seattle Children’s supports your family with a range of resources. Our Child Life specialists, Family Resource Center and Guest Services are here to help.
• Research and advances to improve care
  • Our spine experts are part of national and international research groups. These groups study the latest treatment approaches and technologies. Together, we work to find the best and safest ways to care for children. We are part of the Scoliosis Research Society, Pediatric Spine Study Group, Harms Study Group and Fox Congenital Spine Study Group.
  • Severe early-onset scoliosis, neck problems and congenital spine problems are rare. So, no single hospital treats enough patients to study these conditions well on its own. Through research groups, we join with other top-tier children’s hospitals to find better treatments.
  • We developed advances in monitoring and treatment of scoliosis in very young children. 
  • Seattle Children’s has one of the largest growing-rod programs in the country. We are a leader in studying how growing rods affect children and how well they work.
  • Our surgeons have led research to reduce your child’s exposure to radiation from imaging tests, like X-rays and CT (computed tomography), before and during surgery.
  • Learn more about current orthopedics research at Seattle Children’s.

For most children, we can successfully treat scoliosis with nonsurgical methods. The most common treatments we use are observation and bracing. Sometimes, we recommend Mehta casting, diet or exercise changes or Schroth physical therapy.

• Observation

  This usually means having an exam and X-ray of the spine every 6 months. If your child is growing fast or their curve is getting worse, they may need an exam and X-ray more often. Scoliosis is more likely to get worse during times of rapid growth, like just before puberty.

  To track your child’s growth, it helps to keep a record of their height. Once your child has stopped growing, their spinal curve is less likely to get worse. After that point, we will check them less often.

• Bracing

  A brace is a common treatment for children with curves between 20 and 45 degrees who are still growing. Bracing is not used for children who are done growing.

  The brace is used to prevent the curve from getting worse. It will not make the curve go away.

  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.

  It’s important to fit the brace to your child’s body. We have a great deal of experience in making braces to fit children of all sizes and ages. Read about braces and our other orthotics and prosthetics services.

• Mehta casting

  If your child is age 3 or younger and needs treatment, we may recommend Mehta casting. This means putting a cast around their upper body. The cast pushes the spine straight.

  Keeping the cast on full time gives your child the best chance to grow straighter. The goal is to keep their curve from getting worse — and possibly to make it better. Mehta casting may cure scoliosis in young children who are treated early.

  This treatment is not surgery (no cuts are made to the skin). But the cast is put on in the operating room with your child under general anesthesia. Read more about Mehta casting (PDF).

• Diet, supplements and exercise

  Children who have scoliosis may have a higher risk for weak bones (osteoporosis) later in life. Based on your child’s needs, we may suggest diet changes or supplements. We want to make sure they get enough calcium and vitamin D to help keep their bones strong. Check with your child’s healthcare provider before giving them any vitamin or supplement.

  It’s also important for your child to get regular weight-bearing exercise. This includes movements like walking or running. Regular play and exercise are good for your child’s health and can help prevent back pain. Gym classes are good for children with scoliosis.

• Schroth physical therapy

  The most common type of physical therapy for scoliosis is called the Schroth method. Seattle Children’s has physical therapists (PTs) trained in Schroth physical therapy. It may help some children with small curves.

  With this method, your child learns and practices exercises during visits with a PT. Then they do the exercises every day at home. Read more about Schroth physical therapy (PDF).

• Other options

  You may hear or read about other forms of therapy, such as chiropractic, electrical stimulation, massage or yoga. These do not hurt the spine and may help with back pain. But it’s not clear that they keep scoliosis from getting worse.