Early detection is key to preventing scoliosis from progressing in children

by DR WONG CHUNG CHEK

SCOLIOSIS is common, sometimes hereditary spinal medical condition, in which a person’s spine curves to the side, typically in the shape of an “S” or “C”. A stable and mild case of scoliosis does not cause significant lifestyle issues, but severe cases with prominent curves can be harmful to a person’s health.

People often believe, erroneously, that carrying heavy bags, having poor body posture, participating in sports, or sleeping on one side will cause the spine to bend, but that isn’t quite the case. 

The reality is that over 80% of all scoliosis cases have no known cause. Such cases are known as idiopathic scoliosis.

According to studies, scoliosis affects 2% to 3% of the Malaysian population, or between 600,000 and 900,000 persons. It’s most often detected during adolescence, but it is also known to affect adults and the elderly at a lower rate.

In some cases, this condition can worsen very quickly during adolescence because children often have growth spurts during puberty. Because the signs are not always visible in mild cases, parents should examine their children on a regular basis.

The earlier scoliosis is detected, the better the odds of preventing scoliosis from causing serious issues down the line.

When should you do at-home checks?

The good news is that scoliosis can be easily checked at home by parents. As scoliosis usually starts just before the child shoots up in height, parents should begin looking for symptoms at that time.

Scoliosis usually progresses very rapidly during the growth spurts and only slows down or stops once the child reaches bone maturity. Signs of scoliosis become more noticeable as a child grows in age or as the curve progresses, but that doesn’t mean that scoliosis is impossible to notice early.

An imbalance in the height or position of shoulders, shoulder blades, or hips is one of the most common indications of scoliosis — for example, one shoulder appears to be consistently dropping below the other. 

Another symptom is a misalignment of the head with the rest of the body. Parents should also watch for an uneven waistline or hips, as well as whether one shoulder blade protrudes more than the other.

Should we have posture screening at school?

It might also be beneficial to have posture screening for children in schools, most possibly during regular health checks. This will aid in detecting any symptoms earlier, especially since most children are developing rapidly at this time, which is typically when scoliosis begins to occur. 

Aside from that, it will help to raise awareness about scoliosis, as there is a growing need for education and early detection to prevent conditions like scoliosis from progressing further.

During our consultations with parents, surprisingly, we find that many parents are still unaware that posture screening is available at most health clinics and can point out growth or development related issues in children.

One away to ensure early detection of scoliosis in children is to make early screening accessible in schools. School authorities and government collaborations can be considered in the future to ensure that posture screening is included as part of regular health assessments for children in primary and secondary school.

Do you still need to see a doctor?

If you are still unsure, it is best to consult a doctor as soon as you can. Sometimes mild symptoms may not be easily spotted, and doctors can help perform more tests and X-ray scans.

If you see any signs of scoliosis, regardless of how minor they are, you should schedule an appointment to see a specialist to do further observation and to also check on the severity, as some hospitals may not be able to do a comprehensive check.

If the curve identified is less than 20 degrees, the curve will be observed to ensure that it does not worsen. This is especially important for children who are still developing, although well-grown children may not require more X-rays. 

Such cases may require more testing like MRI, which can be used in addition to the X-rays for more detail. New imaging modality like the EOS is able to provide better images of the spine with a quarter of the radiation dose.

An orthopaedist who specialises in paediatric conditions will be able to recommend more tests, examinations and preventive measures upon further consultation.

While scoliosis is not a preventable condition, measures can be taken for early detection that can slow down the worsening of the condition, thus avoiding surgery. Even in situations where surgery is still needed, early detection would translate to shorter segments and safer surgeries.

Parents and teachers should remain vigilant and place emphasis on good posture habits in young children to allow them to have a safe, health and bright future.

Dr Wong Chung Chek is a consultant orthopaedics and spine surgeon.


Disclaimer: This information is not a substitute for medical consult. If your child is experiencing symptoms like scoliosis, we encourage you to arrange for a consultation.