DEFINING THE CURVE
“If you look at the spine from the front and the back, it should be straight. When scoliosis is present, there is always a sideways ["S" or "C"-shaped curvature] shifting of the spine from the right or left,” says Dr. Aminian. The cause of scoliosis is unknown, but scientists have recently identified genetic markers that are contributing to individuals with it. The condition is more prevalent in girls during their growth spurt years. “Usually, the majority of cases don’t become progressive, but a small subset do and might require surgery in the future,” says Dr. Aminian.
“California is one of a number of states that requires screening students for scoliosis in schools. It’s important that children get screened with their school nurse or their pediatrician,” says Dr. Aminian. The Adam’s Forward Bend Test checks for scoliosis by having the child lean forward and looking at rib asymmetry. Others signs can be shoulder height (when one shoulder is higher than the other), uneven hips and waistline asymmetry.
“If we catch the scoliosis at younger ages and smaller curves, we’re able to control it with a bracing program,” says Dr. Aminian. The more often the customized brace is worn, the better. Some kids may feel self-conscious wearing it at first, but CHOC’s counseling program helps them cope. “We work with them to increase the number of hours they wear it at school. We stress they wear it at night,” says Dr. Aminian. And they can even sleep in it.
STRAIGHTEN WITH SURGERY
“Surgery is reserved for curves that are major that we think will cause problems in the future, including breathing, balance and pain,” says Dr. Aminian. “Luckily, it’s a standardized surgery. It’s very safe and effective.”
- Grades when girls should be evaluated for scoliosis: 5th and 6th Grade
- Grades when boys should be evaluated for scoliosis: 7th and 8th Grade
- Percentage of the population that have a small (insignificant) curve in their spine: 10 %
PHYSICIAN FOCUS: DR. AFSHIN AMINIAN
Dr. Aminian is the director of the CHOC Children’s Orthopaedic Institute. He completed his general surgery internship and orthopaedic surgery residency at Northwestern Memorial Hospital and is affiliated with the Pediatric Orthopaedic Society of North America, the American Academy of Orthopaedic Surgery and the Scoliosis Research Society.
Dr. Aminian’s philosophy of care: “I try to put myself in the parents’ shoes and explain to them in the most common terms what we’re doing and why we’re doing it, reminding them of the hospital’s capabilities.”
Washington University School of Medicine
This article was featured in the Orange County Register on December 23 , 2013 and was written by Shaleek Wilson.