I am forever reminding my teenage daughter to stand up straight, and she is forever telling me that she’s trying. I know that teenagers sometimes have lazy posture, but I am actually concerned that there’s something more serious going on with her spine, like scoliosis. Should I be worried? How can I tell the difference between bad posture and scoliosis?
Every adolescent undergoes so many physical changes that it can sometimes be hard for parents to keep up. In fact, the average American child — boy or girl — will grow about a foot and a half taller between the ages of 9 and 16. The taller a teenager gets, the more obvious his or her poor posture may become, and it is important to know the difference between inattentive slumping and a condition like scoliosis.
Your daughter’s pediatrician should check for scoliosis at her annual physical exam, but it is important to perform at-home checks as well.
Scoliosis manifests itself as a permanent sideways curvature of the spine at rest. A healthy child’s or adult’s spine can flex and bend as needed, but from the back, when standing straight, the spine should appear as a straight line.
To look for the signs for scoliosis, have your daughter stand with her back towards you. Assess for the following: is one shoulder higher than another? Does one shoulder blade stick out farther than the other? Does one arm rest farther away from the body than the other? Have your daughter lean over: is there a bulge on either side of her back?
If the answer to any of the questions is “yes,” make an appointment with a doctor for further evaluation.
Through the use of radiography, a doctor can properly diagnose whether the spinal curvature is scoliosis, determine the degree of curvature, and formulate the best course of action. There are three degrees of scoliosis: mild, moderate, and severe. About 10 percent of adolescents have some degree of scoliosis, but less than one percent of them develop scoliosis that requires intervention. Mild cases of scoliosis often resolve on their own, so a child with mild scoliosis typically will be monitored and reevaluated every six months. Should he or she progress to a moderate case, treatment may include a customized brace to help guide the spine as it grows.
For severe cases of scoliosis, surgery performed by an orthopedic surgeon may be required.
Spinal surgery for scoliosis includes the use of rods that are placed alongside of and secured to the spine, or, in some cases, fusion of the vertebrae, in an operation called spinal fusion.
My colleague Dr. Andrew Merola, who performs these procedures at New York Methodist Hospital, notes that a child’s care in the days following his or her surgery for scoliosis can be crucial. In particular, a high-quality pediatric intensive care unit, which will monitor a child for 48 hours after the procedure, is important.
Luckily, performing an at-home check for scoliosis takes only moments. If there are signs of scoliosis, this can be a first step on the path to proper treatment. And if there are no signs of the condition, the battle to get your teenager to stand up straight must continue. Best of luck!