Patient Information Resources


Long Island Spine Specialists, P.C.
763 Larkfield Road
2nd Floor
Commack, NY 11725
Ph: (631) 462-2225
Fax: (631) 462-2240






Child Orthopedics
General
Pain Management
Spine - Cervical
Spine - General
Spine - Lumbar
Spine - Thoracic

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We just came back from an appointment at the university hospital for our 18-month old son. He is starting to develop a curve in his spine that has us all worried. The doctors don't think there is anything like muscular dystrophy or cerebral palsy causing this. But they don't really know. In the meantime, they want to start treating this with a body cast that will be changed as he grows. Is this how other places treat the problem?

Your child may have a condition referred to as early onset scoliosis (EOS). EOS can be a challenging problem and studies to provide evidence-based treatment just aren't available. According to a recent on-line survey completed by pediatric orthopedic surgeons, treatment varies depending on two major factors: the age of the child and the type of clinic or hospital where treatment is delivered. For example, children under the age of two are more likely to be treated conservatively (nonoperative care). This is true even if there is a severe curve. But by age five, surgeons choose surgery more often to treat severe curves. Children receiving care at a pediatric orthopedic specialty hospital are more likely to be placed in a series of casts designed to gradually straighten the spine as much as possible. Care received at a university-based or private pediatric hospital is more likely to be with bracing. Some of the treatment choices do depend on the equipment present in various settings. Casting tables, halo traction, and customized devices that help regulate the amount of traction force applied aren't always available. Most of the surgeons who responded to this survey had the necessary equipment and made use of it. The intent of treatment for early onset scoliosis (EOS) is to keep the spine as straight as possible using nonoperative approaches until fusion can be done. Serial casting works better for younger children. A child the age of yours (less than two) will almost always receive conservative (nonoperative) care. Delaying tactics like using serial casting are advised for as long as possible without compromising final results. Close (regular) monitoring will be needed to determine if and when a change in treatment is needed.

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