Key Takeaways

  • Pediatric scoliosis and spondylolisthesis are treatable conditions that can often be managed with non-surgical treatments such as bracing and physical therapy.
  • Early intervention is crucial in preventing the progression of these conditions and reducing the risk of long-term spinal damage.
  • Pedicle screw surgery, a minimally invasive procedure, is an effective treatment option for severe cases, helping to stabilize the spine and restore alignment.
  • Regular monitoring and consultation with a specialist are essential to ensure the best outcomes for children diagnosed with spinal deformities, ensuring they remain active and pain-free as they grow.

Spinal deformities can be both painful and disruptive, especially for children and teens trying to live active, healthy lives. These conditions, while manageable, can affect their physical and emotional well-being. Dr. Jason Lowenstein, a leading orthopedic surgeon, recently shared his expertise with fellow pediatricians during a course titled “Hottest Topics in Pediatric Orthopedics for the Pediatric Practitioner.” One of the highlights of the seminar was a demonstration on using pedicle screws to treat scoliosis and spondylolisthesis in children.

Treating spinal issues in children requires a different approach than treating adults because children’s bones are still developing. However, young patients have the advantage of faster healing, so they tend to recover quickly once treatment begins. Some mild spinal deformities can be managed through rest, physical therapy, and bracing. However, more severe cases often require surgical intervention to correct the deformities and prevent long-term complications.

In this article, we will explore common spinal deformities affecting children and adolescents and discuss how pedicle screws can be used to treat these conditions effectively.

Understanding the Spine

The spine, which extends from the base of the skull to the tailbone, comprises vertebrae that play a crucial role in supporting the body, absorbing shock, and protecting the spinal cord. The spine also relies on muscles, ligaments, and tendons to maintain stability. Between the vertebrae are rubbery discs that act as cushions, allowing the spine to absorb the shock of everyday movements.

As we age, various factors, such as personal habits, health conditions, and genetics, can lead to spinal problems. Children’s bones are not fully formed, which makes them more vulnerable to fractures or other spinal issues, especially if they are active in sports. Additionally, some children are born with congenital spine conditions or may develop spinal deformities as they grow.

Common Spinal Issues in Children

Scoliosis

Scoliosis is when the spine curves sideways, forming a “C” or “S” shape when viewed from the back. This curvature is most often found in the upper or middle back, though it can also affect the lower back in some cases. Scoliosis can develop due to idiopathic reasons (without a known cause), congenital defects, or underlying health issues such as cerebral palsy or Marfan’s syndrome.

In many cases, mild scoliosis does not require treatment but should be monitored regularly. A scoliosis brace may be recommended for curves between 25 and 45 degrees to prevent further progression. However, more severe curves—especially those over 45 degrees—require surgery to stabilize the spine and prevent the curve from worsening.

Spondylolisthesis

Spondylolisthesis occurs when one vertebra slips over another, often due to a fracture in the back portion of the vertebra. This condition can develop due to repeated stress, such as hyperextension of the back during sports activities like gymnastics, football, and wrestling. While this may seem like a serious condition, it’s quite common in children, particularly those involved in activities that put strain on the lower back. In fact, nearly 1 in 10 children may have some form of spondylolisthesis, many of whom experience no symptoms.

If a child complains of back pain after physical activity, taking the symptoms seriously is important, as they may indicate spondylolisthesis. Treatment typically involves conservative methods such as strengthening exercises, physical therapy, and in some cases, bracing. If the condition worsens or causes neurological symptoms, surgery may be necessary.

Correcting Spinal Deformities with Surgery

Every child’s spinal condition is unique, so it is crucial to have an accurate diagnosis and personalized treatment plan. In cases where conservative treatments don’t provide relief or the spinal deformity is severe and painful, surgery may be required.

Using Pedicle Screws to Correct Scoliosis and Spondylolisthesis

When surgery is needed, pedicle screws can be used to correct spinal deformities such as scoliosis and spondylolisthesis. Pedicle screws are often part of spinal fusion surgery, which involves realigning the spine by making cuts in the bones and inserting bone grafts to help them fuse.

Pedicle screws are placed into the vertebrae of the spine, and a rod is inserted to connect the screws, providing stability during the healing process. This procedure is minimally invasive, as the surgeon uses small incisions and a camera to guide the placement of the screws. The titanium screws anchor the spine, while bone grafts help fuse the vertebrae. Over time, the spine becomes stable, allowing the child to return to normal activities after recovery.

Choosing an Expert for Your Child’s Spinal Deformity

When correcting spinal deformities in children, finding a trusted expert is crucial. Dr. Jason E. Lowenstein, MD, is a board-certified orthopedic surgeon specializing in pediatric spine surgery and scoliosis treatment. He is a partner at The Advanced Spine Center and serves as the Director of Scoliosis and Spinal Deformity at Morristown Medical Center in New Jersey. Dr. Lowenstein is known for his expertise in minimally invasive techniques to treat spinal deformities, including scoliosis and spondylolisthesis.

Conclusion

Correcting pediatric scoliosis and spondylolisthesis requires a careful and individualized approach, given the unique nature of treating growing children. While conservative treatments such as physical therapy, bracing, and strengthening exercises are often effective, more severe cases may require surgical intervention. Surgical techniques, such as the use of pedicle screws, have revolutionized spinal deformity correction, providing long-term stability and relief.

Early detection and intervention are key to ensuring the best possible outcome for children facing these conditions. With the right care and treatment, children with scoliosis or spondylolisthesis can lead active, pain-free lives and avoid long-term spinal issues.

FAQs

1. How is scoliosis diagnosed in children?

Scoliosis is often diagnosed during routine check-ups, where a pediatrician may observe physical signs such as uneven shoulders or a misaligned spine. If scoliosis is suspected, imaging tests such as X-rays, CT scans, or MRIs are used to confirm the diagnosis and measure the degree of curvature.

2. What are the symptoms of spondylolisthesis in children?

In many cases, children with spondylolisthesis may not exhibit obvious symptoms. However, they may experience lower back pain, stiffness, or muscle spasms, especially after activities that put stress on the spine, such as sports. In more severe cases, they may also experience numbness, tingling, or weakness in the legs.

3. Is surgery always necessary for treating scoliosis or spondylolisthesis?

Not always. Many cases of scoliosis and spondylolisthesis can be managed with non-surgical treatments like physical therapy, bracing, and strengthening exercises. Surgery is usually reserved for severe cases or when conservative treatments do not provide relief.