Updates

Scoliosis and Spinal Deformity Program

 Programs and Services

The goal of treatment is to stop the progression of the spinal curve and minimize deformity. At Texas Children’s, we aim to treat scoliosis and spinal deformities with a non-surgical approach first. Our multi-disciplinary spine team will work with each patient to create a customized treatment plan that works best for their needs. These interventions include:

  • Schroth Method: Through physical therapy and breathing techniques, the Schroth Method helps improve posture, restore alignment and increase body symmetry. With this approach, exercises are customized for each patient to help the spine return to a more natural position. Learn more.
  • Bracing: For patients with moderate scoliosis, our spine specialists may recommend the use of a brace to keep the spinal curvature from progressing as they grow. Braces are molded to the individual patient and will improve posture by putting pressure on the outer edge of the spinal curve. Scoliosis braces are typically lightweight and can be worn under clothes. Patients may need a combination of bracing and physical therapy to see results and avoid surgery.
  • Gait Analysis: Many spine patients take advantage of the Human Performance and Motion Analysis lab located at Texas Children’s Hospital The Woodlands. The team of physicians, therapists, biomechanists, and exercise physiologists analyze the impaired gait in children and provides 3D gait analyses that are used to guide surgical and/or spasticity management recommendations. Learn more about the Human Performance and Motion Analysis Lab here.

When spinal surgery is required, Texas Children’s offers the most advanced approaches and techniques. Our multi-disciplinary surgical team utilizes 3D printing capabilities, which creates a patient-specific model of the spinal issue and helps the surgery team to plan a more accurate recovery process.

Additionally, our spine surgeons have a C-Arm Surgical Imaging System available during each procedure which allows them to easily check anatomical details, like bones and soft tissue, to monitor progress and make adjustments during surgery.

Common spine surgery methods include:

  • Tethering Correctional Surgery: Vertebral Body Tethering (VBT) is most commonly used for patients with idiopathic scoliosis that has not been corrected with nonsurgical methods. This minimally-invasive procedure is recommended for patients with a moderate to significant spinal curve who are not yet finished growing. VBT uses a tether that is pulled tight along the spine, and as the patient grows, the tether helps the spine straighten out.
  • MAGEC™ Remote Control Growing Rods: MAGEC growing rods, part of the Magnetic Expansion Control system, is a new surgical treatment for children with severe spinal deformities. After a minimally-invasive procedure to implant the rods, an external remote control is used to lengthen or retract the rods as needed to straighten the spine. With MAGEC, there is no need for repetitive spine-straightening surgeries which can improve quality of life.
  • Spinal Fusion: Spinal fusion surgery is most commonly recommended for patients with neuromuscular scoliosis, and completed once they stop growing. With this option, the spine is fused permanently to reduce pain, increase stability and prevent the curve from worsening.

After Spinal Surgery

All patients, their conditions and their surgery pathways are different, but most patients stay in the hospital for 2-5 days following spinal surgery. Your care team will provide detailed instructions on diet, medication, wound care, dressing care and instructions for returning to school and activities. A follow up appointment will be scheduled one week after surgery to check incisions and monitor mobility.

Surgical Options in Your Community

Spine surgery for adolescent idiopathic scoliosis is now available at our Woodlands campus, with plans for further expansion to West Campus.

To accurately diagnose scoliosis and other spinal deformities, physical exams, X-rays, MRIs and bone scans may be used. If there is a curve detected, the spine specialist will measure the curve in degrees. From there, the spine team will work with the patient and their families to discuss treatment options based on the:

  • Degree, type and location of the curve
  • Age, health and medical history of the patient
  • Underlying cause of deformity
  • Extent of the condition
  • Patient’s tolerance for specific medications, procedures or therapies
  • Expectations for the course of the condition
  • Patient family’s opinion or preference

Diagnostic X-Rays

Many parents are concerned about exposing a child with medical conditions to frequent X-rays. Texas Children’s Hospital was the first pediatric institution in the southwest to adopt the EOS low dose X-ray, which emits significantly less radiation than traditional imaging technologies. A determination for treatment can often be made based on this measurement alone.

Other diagnostic tests include:

  • Bone Scans: Bone scans are a nuclear imaging method to evaluate any degenerative and/or arthritic changes in the joints. It also can detect bone diseases and tumors and can determine the cause of bone pain or inflammation. This test is to rule out any infection or fractures.
  • Magnetic Resonance Imaging (MRI): This diagnostic procedure uses a combination of large magnets and a computer to produce detailed images of organs and structures within the body. This test is done to rule out any associated abnormalities of the spinal cord and nerves.
  • Computed Tomography (CT) Scan. A CT scan uses a combination of X-rays and computer technology to produce horizontal images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat and organs. CT scans are more detailed than general X-rays.
  • Blood Tests and Physical Exams: Early detection of spinal conditions is important for successful treatment. Pediatricians, family doctors and some school programs routinely look for signs that spinal deformities may be present.

At Texas Children’s, every patient with neuropathic scoliosis is considered for surgery. Our multi-disciplinary team of spine surgeons, neurosurgeons, pulmonologists, anesthesiologists, nutritionists and critical care specialists evaluate every patient using a six-phase evaluation, screening and approval process.

Each patient’s medical and surgical plan will be reviewed by this team on at least two occasions leading up to surgery. There may be some delays in surgery scheduling if the patient requires further testing or optimization of other medical conditions prior to surgery. Although we know delays can feel frustrating, our goal is always to make sure our patients have the best and safest possible experience with their spine surgery.

Working with a Nurse Coordinator

If approved for spinal surgery, the patient and their family meet with a nurse coordinator to learn what to expect, make travel arrangements if needed, and complete any pre-operative workups. During this time, some patients may take part in a sleep study and meet with a nutritionist to ensure they are healthy enough for surgery. If a patient is not yet medically ready for surgery, or if significant issues arise, it is possible surgery may be cancelled or rescheduled. The nurse coordinator will serve as a liaison for the patient and their family as they navigate spinal surgery preparation and recovery.

 

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