When Your Child Needs Scoliosis Surgery,
Only the Best Will Do
When Paul Burnside suspected his teen daughter had scoliosis, he talked to a relative who is a nurse practitioner. She told him that Michael Albert, MD, at Dayton Children’s was the best for this type of procedure. His decision was made. “I wanted Shirray to be seen by the best doctor available.”
Shirray is standing a little straighter and taller this year—and not just because she is a happy, outspoken and self-confident 17-year-old. Shirray, a student at Stivers School for the Arts in Dayton, spent a good part of 2009 recovering from scoliosis surgery.
Her journey began at the start of 2009 when her 12-year-old sister Shirneal came home from school talking about the scoliosis screening she had gone through. Shirneal decided to screen her big sister. As her hands pressed on Shirray’s back, Shirneal could feel a distinct curve to her spine. Paul Burnside, the girls’ father took action. Shirray’s aunt, a nurse practitioner, told Paul that Michael Albert, MD, at Dayton Children’s was the best for scoliosis surgery.
On February 13, the Burnsides met with Dr. Albert, director of orthopedics at Dayton Children’s, and were immediately reassured. “Going ahead with Dr. Albert was not a hard choice. We trusted him and were impressed with his outcomes.” In addition to the physical exam, Dr. Albert had x-rays taken of the teen’s spine to confirm that she actually had scoliosis and to determine the degree of her spinal curve.
Diagnosis and scoliosis surgery
“Shirray was diagnosed with adolescent idiopathic scoliosis. Through testing, we determined she had a 55-degree curve to her spine. Usually, any curvature greater than 50 degrees is corrected by surgery,” Dr. Albert explains. Like Shirray’s sister, most children with scoliosis are identified during a school screening, usually in the sixth, seventh or eighth grade. “The sooner a child is diagnosed, the easier it is to correct the curve without surgery and that is always our preference,” he says. Unfortunately, Shirray was not diagnosed until she was 16. Because she had started puberty, bracing was not an option.
The team approach to care in pediatric orthopedics at Dayton Children’s is especially important to kids like Shirray and their families who have a lot of questions and concerns about major spinal surgery. “My main question for Dr. Albert was ‘Will I be paralyzed?’ He assured me this was very unlikely,” Shirray recalls. She adds that he described the entire process in great detail and assured her she would once again resume her active lifestyle. “The staff also put me in touch with another girl who had gone through scoliosis surgery and was doing fine. This made me feel a lot better about my decision.”
Shirray was scheduled for surgery July 9, 2009 so she would not miss any school and could recover over the summer. Shirray was in the hospital for a week. After resting the first few days, Shirray was fitted for a brace. She was soon walking the hospital hallways with assistance and went home shortly after. Her brace came off on November 9, 2009. “It felt so good to take a shower without the brace for the first time in four months.”
A full recovery
Shirray is now fully recovered and is starting her senior year at Stivers, where she is in the creative writing magnet program and studies piano. “Before I had scoliosis surgery, my back hurt a lot, especially when carrying my backpack for school. Not only is the pain gone now, but I feel I’m more outgoing and say what’s on my mind,” she explains.
“Although I felt bad that Shirray had to have surgery, we’re so satisfied with the outcome,” Paul says. “I’m proud of the way Shirray handled everything—asking lots of questions and accepting the brace. She didn’t try to hide the brace and would talk to people about scoliosis. We’ve been very happy with Dayton Children’s, Dr. Albert and his staff.”
It’s no accident that the orthopedics team at Dayton Children’s inspires such confidence. “My partner Jim Lehner, MD, and I have over 50 years of combined experience in treating children with scoliosis and performing other spinal surgeries,” Dr. Albert says. Dayton Children’s performs the majority of the 120 spine surgeries done in the entire 20-county region in a year. This level of experience is not available at any other facility in those 20 counties.
That degree of expertise is essential when looking at a complicated surgery that typically lasts from four to six hours (see article in this issue on the importance of pediatric anesthesia.) Scoliosis surgery is a spinal fusion that involves pins and screws and placing metal rods in the child’s back. Because the spine is three-dimensional, the surgeon needs to consider the placement of this “hardware” very carefully to ensure the best outcome. Drs. Albert and Lehner, like the other orthopedic doctors at Dayton Children’s, are board certified and fellowship trained in pediatric orthopedics.
This extra training, experience and clinical expertise can only be found in a hospital dedicated to caring for infants, children and teens. Dayton Children’s is proud to bring this expertise to its 20-county region.
“We chose Dayton Children’s because of Dr. Albert’s experience, the tremendous staff and the team approach,” Paul says. “We were complete strangers to them when we first arrived, but the entire staff treated us like family.”
More About Scoliosis and Screening
What is scoliosis?
Every person’s spine can curve, and a certain amount of curvature is needed for us to balance, move and walk properly. But two to four percent of children between 10 to 16 years of age are diagnosed with adolescent idiopathic scoliosis.
In some cases, children with scoliosis may wear a back brace, which is sufficient for correcting the curve. Although braces prevent surgery about 60-70 percent of the time, some children will need to have surgery to correct their curvature.
“Our approach at Dayton Children’s is to first try bracing if a child’s curve needs correcting. Surgery is not the first treatment option,” says Michael Albert, MD, director of orthopedics. “However, if a child has 50-degree curve or greater, surgery may be the best option, and we discuss all choices with the child and his or her family,” he explains.
Scoliosis: early detection is key
Scoliosis affects close to three percent of girls and boys each year. It is typically diagnosed through screenings in schools or primary care offices when children are between the ages of 10 and 14 years. As they enter adolescence, girls are eight times more likely to have their spinal curvature increase and require treatment. The cause for most types of scoliosis is unknown.
Some symptoms of scoliosis are:
One shoulder or shoulder blade looking higher than the other
- Extra space between the arm and body when arms hang straight
- One hip more prominent or higher than the other
- A head that is not centered over the pelvis
- One side of the back higher than the other when bending over
Fortunately, 90 percent of cases do not require treatment other than occasional monitoring by a pediatric orthopedist. Other forms of treatment include periodic x-rays, brace (orthosis) or surgical treatment. Although scoliosis is often minor, treatment from a pediatric orthopedist can prevent back pain, arthritis, spine twisting, clothes not fitting correctly and in rare cases heart and breathing problems.
The experts in the division of orthopedics at Dayton Children’s have over 50 years of experience treating spinal conditions in adolescents.
For more information on scoliosis and its treatment, follow this link to numerous resources on this website.
Visit our orthopedics center and see Patient Education - Spine Animation
Scoliosis screening in schools
Dayton Children’s pediatric orthopedics division will be helping area schools with scoliosis screening beginning in November. Free screenings will be provided to junior high school students throughout the region. Students identified with a possible spine curvature will be referred to their primary care doctor, who will perform a follow-up screening. If your child’s doctor feels it is necessary, he or she can refer your child to a pediatric orthopedic specialist. Talk to your child’s doctor if you have questions about this program.
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