DEAR DR. GOTT: My 17-year-old son has scoliosis. We have seen a specialist who had him wear a brace, but he couldn’t breathe with it on. I think it’s now time for surgery, but his primary-care doctor wants him to wait. What should we do and how long should we wait?
DEAR READER: Children and teens with mild scoliosis are often monitored with X-rays periodically to determine whether the curvature worsens. In many instances, treatment isn’t necessary. A brace will not cure the condition, nor will it reverse the curvature, but it may prevent advancement. There may come the time when surgical intervention is appropriate.
Symptoms may begin during growth spurts, commonly prior to puberty. Treatment is on a per-case basis. After growth has stopped, the risk of advancement of the scoliosis is low. Your son’s bones are likely still growing, making a brace more appropriate. There are two types available. The first and most common fits under the arms and around the rib cage, lower back and hips. The second and less popular because of its bulkiness is a full-torso brace with flat bars, and stabilizers for the back of the head and chin. Either brace should be worn as much as possible in every 24-hour period, and children and teens are encouraged to stay active with exercise and sports. Perhaps he should return for a better-fitting brace that won’t impair his breathing.
Your son’s doctors are the only ones capable of determining when surgery is warranted. Spinal fusion is not to be entered into lightly. Return to your son’s specialist to discuss what options are available to him. If you are dissatisfied, request a second opinion to a top-notch orthopedic surgeon who specializes in young-adult scoliosis.
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