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Dear Doctor

July 2017

Question:

My daughter was diagnosed with scoliosis in August with 38/24 curves. She has worn a Boston brace since November. In June she had her first out of brace X-ray and measured 51/38. The doctor says surgery, but surgery is not an option for our VERY active daughter. We are considering ScoliSmart. Have you heard about ScoliSmart? Will this possibly help? What are her options? If we don't do surgery what are her risks in the future?

- Qwen - Pennsylvania (Parent)

Answer:

Without knowing your daughter’s age or how mature she is (how close her bones are to being done growing), I can’t give you exact advice on what I would do. However, ScoliSmart is only useful for very specific and usually small, flexible curves. That program/brace has published research showing that even after a year of brace wear and exercise curves only improve by 6 degrees (published on their website). Attempting to correct your daughter’s curve with ScoliSmart will only leave you frustrated, with time and money wasted. I think your doctor is concerned about how quickly your daughter’s curve got bigger, especially while she was wearing her brace. Talk to him or her about giving it another 6 months (while braced), but if the curve still progresses over another 6 months, then you know that surgery is necessary. Spine surgery is done for two reasons – one is to make an existing curve smaller, but the second is to prevent further progression of the curve. Large scoliotic curves will eventually compromise heart and lung function because they alter the size and shape of the chest, as well as it’s ability to expand and contract (which affects lung function). Also, having spine surgery does not mean an end to your child’s active lifestyle. There are professional golfers and gymnasts who have had spinal fusion surgery for scoliosis and are active at the highest levels. My patients have gone back to running, mountain climbing, rowing, football, and all sorts of other activities. One just broke her collar bone playing lacrosse! I’m sure this seems scary, but spine surgery is not the end of the world, and if your child’s spine is progressively curving, it may be your best option.

- Qwen - Pennsylvania (Parent)