When patients present with moderate spinal curves, many pediatricians are unsure of the best approach to the next steps. Certainly, for a large Cobb angle, they would refer immediately. But what about a 15-degree curve? When it comes to scoliosis referrals, sooner is always better than later.
A proactive approach can ensure patients have the full range of treatment options. At UVA Health Children’s, our pediatric scoliosis department has made a commitment to local providers: we'll see all patients within 2 weeks. We do this not because there’s a shortage of children needing orthopedic care, but because we know the difference early intervention can make.
When Is Screening Appropriate?
Young children’s spines are more malleable, and that makes low-intensity interventions more likely to have long-term success. At UVA Health Children’s, our prosthetics and orthotics department works with our board-certified orthopedists to find solutions that work for children with idiopathic and neuromuscular scoliosis. Our outpatient therapists can also help assess and develop exercises to help correct problems early.
Doing the Adams forward bend at wellness visits early and often gives pediatricians the best chance of catching scoliosis early. While most scoliosis starts in adolescence, congenital scoliosis is present at birth, and early-onset scoliosis can start during infancy. Even though this screening takes only 10 seconds, early detection can ensure early intervention to help manage curve progression.
For a long time, this screening was controversial because there is a high risk of false positives. But now that we have access to low-radiation imaging and more noninvasive options, there’s no reason not to screen before patients become symptomatic.
Getting Harder to Measure Curves
The growing rates of children with obesity have also made it more challenging to detect spinal curvatures. Traditionally, the approach has been to ask patients to bend forward, which made their vertebral bones prominent and easy to measure.
But an AAP study showed that patients with obesity often have significantly greater spinal curves than could be assessed visually. While the suggested reading on a scoliometer for referral is 7 degrees, for patients with obesity, the threshold is 5 degrees.
Will I Be Asked for an X-Ray?
Some pediatricians delay referring because they want to be certain first. X-rays can be useful for confirming a suspected diagnosis. But if your office doesn’t have access to an X-ray machine, we can provide imaging as well.
At UVA Health Children’s, our pediatric radiology department has access to the newest equipment. That includes imaging machines that deliver the least possible radiation. Our imaging professionals are experts in working with families and can alleviate nervousness and concerns.
Bracing, Surgery, & Physical Therapy
UVA Health Children’s offers the full spectrum of care, from monitoring to braces expertly crafted by our pediatric orthotic specialists to complementary therapies offered by our integrative health team. We want to help your patients have the tools they need to handle scoliosis.
Spinal surgery has evolved, and we’ve kept up with every innovation. New techniques allow us to help find the right solution for every family. Minimally invasive options can help patients recover more quickly, and our board-certified orthopedic surgeons have the expertise to guide patients with confidence.
For over a decade, we’ve participated in international research, evaluating not just immediate outcomes, but also long-term results. This perspective helps inform our joint decision-making and leads to better patient satisfaction.
We’re Here to Help You Care for Your Patients
Scoliosis can be challenging for families. But when their pediatrician and orthopedist are communicating regularly, it’s easier for them to get continuity of care. It also alleviates the burden of tasking patients themselves with delivering information between the two offices.
When you refer a patient to us, we’ll keep you informed about their treatment and follow-up appointments. We’ll also be available to answer your questions about how you can facilitate their healing and recovery.