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Dear Doctor

August 2019

Question:

My 6-year-old doctor was just diagnosed with scoliosis with a 25% curve. The pediatric orthopedist told us she would need to wear a brace for 18 hours each day until she stops growing, so approximately 8-10 years. He also recommended an MRI. Is this something that we should seek a second opinion for or is this pretty standard as far as treatment goes? I'd hate to make her wear a brace for the next 8-10 years if it isn't completely necessary. Please advise.

- Mary - New Jersey (Parent)

Answer:

Hello, and thank you for your question. Your daughter has juvenile scoliosis, which means scoliosis that is diagnosed between the ages of 4 and 10 years of age. An MRI is part of the standard workup for scoliosis in this age group because approximately 20 percent of juvenile scoliosis children will have something in the spinal column causing the scoliosis, such as a tethered cord (where the cord gets “stuck” in the spine causing a “tether” preventing normal growth and leading to the scoliosis). About half of these found conditions require surgical intervention to treat. An MRI is the only way to see this. The problem with scoliosis is that it is highly dependent on the growth available in a child. The younger a person is at the time of diagnosis, the more time they have to grow and therefore the more time for the scoliosis to worsen, or progress. Bracing has been shown to prevent progression, but not necessarily correct the curve found at the beginning of bracing. Our whole goal in bracing is to try and save your child from scoliosis correction surgery long term. I would highly recommend the brace. It seems like a pain, and at times challenging, but it will help your child in the long run if the brace is successful. I hope this helps!

- Mary - New Jersey (Parent)