spine and scoliosis program
surgery | rehab | imaging | screening
Few pediatric hospitals see as many pediatric patients with scoliosis and other spinal conditions as the U.S. News & World Report ranked orthopedics division at Dayton Children’s. We specialize in all types of treatment for scoliosis and other spinal conditions, including non-surgical and minimally invasive options. Our doctors are at the forefront of cutting-edge research and innovation, including being involved in the early development of ApiFix and BandLoc spinal surgery. Continue reading for more information about our spinal and scoliosis program.
Every person’s spine can curve. A certain amount of curvature is needed for us to balance, move and walk well. Scoliosis is a condition that causes the spine to curve into an ‘s’ shape. If the curve becomes bad, it can be noticeable. If the curve becomes very bad, it can lead to other health problems, sometimes affecting the lungs, heart and muscles. Scoliosis can happen over time. In most cases, it isn’t found until a child is between 10 and 14 years old. Most cases of scoliosis don’t need treatment. But even when they do, most of the time kids can continue an active life after treatment.
In 90 percent of cases, curves are mild and do not require active treatment, but should be monitored for change. If you suspect your child has scoliosis, please contact your pediatrician or family physician.
In those that require treatment, modern bracing can be used on the majority of them to prevent progression and the need for surgery. When a child does meet the requirement and is cleared for surgery they will be treated by one of the world-class spine surgeons at Dayton Children’s.
Dayton Children’s performs the majority of pediatric spine surgeries done in our region. This level of experience is not available at any other facility and is the reason families outside our region seek care from our spine experts.
signs of scoliosis
There are certain signs and symptoms that your child's pediatrician will monitor to check for scoliosis. They are:
- One shoulder may be higher than the other
- One shoulder blade (scapula) may be higher or more prominent than the other
- Extra space may exist between the arm and the body when arms are hanging at the sides
- One hip may appear to be higher or more prominent than the other
- The head is not centered over the pelvis
- When bending over so the back (spine) is horizontal, one side of the back may appear higher than the other
Most people (85%) with scoliosis have the type known as idiopathic, which means the cause is not known. The main reason the spine curves is the uneven growth of the back bones (vertebrae). Idiopathic scoliosis is often seen in family members and may be genetic. Larger curves occur more often in females than males. However, males can also develop severe spinal curvature.
Some patients show clear signs of scoliosis. Sometimes a curvature of the spine is obvious. The ribs are pushed out or one shoulder blade is noticeably higher than the other one. Other times it’s not so obvious. Scoliosis doesn’t hurt or happen suddenly, it’s not always easy to diagnose. Some schools in the United States test for scoliosis. The Dayton Children’s scoliosis team of doctors and nurses work directly with schools to screen for spinal deformities.
A scoliosis curve of 10 to 15 degrees usually means that nothing needs to be done except for routine checkups until pubertal maturation and growth are done. The curvature of the spine usually doesn’t get worse after that point. Most of the time, scoliosis is mild enough that it doesn’t affect a child’s life and requires no medical treatment. In some cases, doctors will have a child with scoliosis wear a back brace or do surgery to correct the problem. If the curve is 20 to 40 degrees, the orthopedist may suggest a back brace for younger patients. Keep in mind there is some variation due to minor position changes during the X-ray. This means that the number will change a little from one X-ray to another (up to about 5 degrees), even though the curve hasn’t changed. With the right kind of treatment —whether it involves observation, wearing a brace or surgery— almost every child with scoliosis can have an active, normal life.
back braces and surgery
About 20% of kids with scoliosis need to wear a back brace. The brace acts as a holding device that keeps the spine from developing more of a curve. A brace won’t make the spine straight, but if it does its job well, the curve won’t increase more than 5 or 10 degrees and surgery can be avoided. The many different types of back braces are typically made of lightweight materials. Some braces are made to be worn 18 to 20 hours a day, while others are worn only at night. Several different types of braces are used. The one that the orthopedist chooses depends on the child, the location of the curve and the severity of the curve. The most common type is a TLSO (thoracic-lumbar-sacral-orthosis) brace, which is a low-profile brace (comes up under the arms and fits beneath clothes). Another common brace is the Providence brace which is only worn at night. Sometimes, even with a brace, surgery becomes necessary to correct the curvature of the spine. Overall, braces prevent surgery about 70-80% of the time.
The U.S. News and World Report ranked orthopedics division is led by division chief Michael Albert, MD.
Dr. Albert and his team work continuously to offer cutting-edge, minimally invasive options that gets kids back to school or their sport quickly while preserving their long-term growth and development.
Dr. Albert was the first surgeon in Ohio to use 3D printing technology called FIREFLY® Pedicle Screw Navigation Guides by Mighty Oak Medical through a partnership with OrthoPediatrics. The technology allows doctors to print a scale model of the spine to plot the most efficient placement of screws before the surgery, leading to safer, more accurate and faster operations.
Dr. Albert also serves as the surgeon advisor for AMB Surgical II, LLC, a medical device developer and owner of the FLYTE™ Smart Automated Growing Rod (SAGR) technology. Through the use of this technology, which uses magnets and mechanics to help lengthen and straighten spines and limbs, children will no longer be subjected to repeated surgeries to correct limb and spinal deformities.
Additionally, medical device companies and engineers seek Dr. Albert's input on new equipment, devices and technologies. His designs to provide better care for scoliosis patients have been incorporated into many of the systems in use today across the country. Under his leadership, Dayton Children's now offers patients several minimally invasive options to correct a spinal curve.
BandLoc spinal procedure
Pioneered by Dr. Albert, the BandLoc spinal surgery procedure was designed to allow more efficiency in surgery and gain a better correction outcome. BandLoc is a specialized sublaminar polyester implant that is used to improve spinal deformity and correction. Think of it like a big zip tie made of polyester. The surgeon weaves the polyester band from pins and rods through the spine. The bands are simple, versatile and powerful, gradually correcting even large spinal deformities with no bone or band failures.
BandLoc is designed with the pediatric patient in mind:
- Designed and tested to specifically address the distinct needs of pediatric patients with spinal deformities
- One of the only spinal systems cleared for pediatric application on the market by the FDA
- The system takes the place of screws which are difficult to place in some spinal curvatures
- Can reduce the risk of infection and create a better correction outcome
ApiFix is a minimally invasive approach to correct a spinal curve in
young people with scoliosis. The ApiFix device allows our spine surgeons to perform a surgical curve correction while retaining spine flexibility. The main purpose of surgery is to stop a child's spinal curve from getting worse.
The unique ApiFix approach provides an alternative to failed bracing before considering spinal fusion for many patients as the least invasive spine deformity correction option. The ApiFix device acts as an internal brace and naturally expands as the child grows or exercises.
Recovery following ApiFix surgery is relatively pain-free and is measured in days, not months – children are discharged from the hospital in 1-2 days and return to school in 1-2 weeks! Learn more about ApiFix at Dayton Children's
As part of our spinal and scoliosis program, we offer a therapy program called Scolio-Pilates. This exercise program combines pilates movements with therapy exercises to help with:
- Elongation of the spine and posture
- Corrective breathing techniques
- Corrective placement toward spinal neutral
Learn more about Scolio-Pilates at Dayton Children's.
experience the EOS difference
what is EOS medical imaging?
The EOS imaging system is a low-dose, 3-D imaging system that scans your child standing up. An EOS scan shows us your child's natural, weight-bearing posture and allows us to see the interaction between the joints and the rest of the musculoskeletal system, particularly the spine, hips and legs.
benefits of EOS
EOS imaging uses an ultra-low dose of radiation to provide extremely detailed, high-quality images. It uses a significantly lower radiation dose than a general radiography X-ray. With EOS scans, we can make more informed diagnoses and create individualized treatment plans for children with musculoskeletal disorders.
reduced radiation dose
We take every safety precaution and have set the standards for reducing children's exposure to radiation across all imaging tests and
procedures. The EOS technology is yet another tool that enables us to provide the best imaging services while reinforcing our commitment to safety and low-dose imaging options for our patients.
- EOS delivers a radiation dose that is two to three times less than a general computed radiography X-ray and 20 times less than basic computed tomography (CT) scans.
- Reducing radiation dose is particularly beneficial for children who need to be imaged frequently, such as children with spinal deformities like scoliosis.
better diagnostics and image accuracy
- 3-D weight-bearing images of children in an upright, standing position give us the most accurate view of the spine and lower limbs. Physicians can better evaluate balance and posture and analyze the bones, joints and ligaments from multiple angles.
- This type of imaging enables us to view all areas of the body with one image, rather than stitching together multiple images. It gives us an accurate view of the musculoskeletal system that is essential to diagnosis and treatment planning.
when is EOS used?
EOS imaging offers 3-D weight-bearing images physicians can use to get the most accurate view of your child's spine and lower limbs in a natural standing position. The EOS imaging machine is primarily used to assess patients with spine, hip, and leg disorders.
for school nurses: bring this program to your school
As a school nurse, we know that you are stretched with both your time and budget and that it can often be difficult to find the time to perform scoliosis screenings. That is why we want to partner with you! If you are interested in bringing this program to your school please contact us at 937-641-5323 .