Observation

Why so many examinations?

When it comes time for treatment, our goal is to stop the curve from getting worse and to prevent future problems. Not all curves need treatment. Most curves will remain small not get bigger or cause any problems. However we can not predict yet if small curves under 20 degrees are going to progress in the very young. So rather than jumping into unnecessary interventions, our orthopedic specialists may monitor your child if his or her spinal curve is less than 20 degrees.

Why does my child need so many X-rays?

Finding scoliosis early is very important for successful treatment. Due to the number of repeat examinations we have cutting edge technology to limit your child's radiation exposure.

• EOS: Children's Wisconsin is one of the very few hospitals with an EOS low-dose radiation scanner. When a child has scoliosis, doctors follow his or her growth and development carefully. One of the most important advantages of using the EOS scanner is the large decrease in radiation dose up to 10 times less than a regular X-ray, and up to 99 percent less than a CT (computed tomography) scan of the spine. In less than 20 seconds, the EOS scanner can take a 3-D, head-to-toe image of your child in a standing, weight-bearing position. EOS images also provide sharper detail, helping providers better decide the right course of treatment and, over time, measure the results of that treatment for children and families living with long-term health conditions like scoliosis. Explore more about the EOS scanner benefits and watch a parent's testimonial video.
• 3-D spinal measurement system: Children's is one of the only centers in the country to use the 3-D spinal measurement system, a system that does not use radiation. This system allows us to measure at least 12 different points along the entire length of a child's spine. The 3-D spinal measurement system creates a surface map of the spine so we can measure the change in a child's spinal curve and properly treat his or her scoliosis. It is most commonly used for patients with smaller curves.

What kind of therapies can we do?

Sometimes physical therapy is included especially if the patient is having pain or the family would like to seek other methods. Physical therapists work very closely with your child's team of orthopedic specialists to ensure your child's curve is closely monitored and care best meets your child's specific needs. We have a very conservative approach to care.
We'll work with you and your child so you understand treatment goals. Treatment goals may include sitting with better posture, participation in sports and recreational activities, or simply feeling better about the way he or she looks.

There is not good evidence that physical therapy, manipulation or electric stimulation to keep scoliosis size from getting bigger. However, our physical therapists at Children's use special exercises to help manage scoliosis. These exercises are based on your child's individual curve and activities, whether he or she has pain, and current strength and flexibility. Physical therapy may be a part of your child's scoliosis treatment plan because it can improve pain, breathing, posture, balance, movement and overall quality of life.

Every child's needs and goals are different. Our highly trained physical therapists have found that patients have the best results when we use a variety of treatment methods to manage scoliosis. We use elements of a research-based method called the Scientific Exercise Approach to Scoliosis, as well as other physical therapy methods, to develop a very individualized and practical approach to care. Our goal is to make sure patients develop a greater awareness of their posture and provide them with the tools to maintain improved posture. We do that through:

• Flexibility training
• Balance and coordination activities
• Retraining breathing and posture
• Strengthening and conditioning exercises
• Therapy and massage techniques