The majority of scoliosis occurs in adolescence and is “idiopathic,” meaning its cause is unknown. It usually develops in middle or late childhood, before puberty, and is seen more often in girls than boys. Although scoliosis can occur in children with cerebral palsy, muscular dystrophy, spina bifida and other miscellaneous conditions, most scoliosis is found in otherwise healthy adolescents. If allowed to progress, scoliosis can lead to chronic severe pain, deformity, and difficulty breathing.
We Are Committed to Your Care and Treatment
We are a team committed to the highest quality of care in diagnosing and treating spine deformity for pediatrics and adults. Our goal is to get each patient “back to normal”— physically, functionally and cosmetically.
Dr. Richard Francis
Dr. Richard Francis is one of the few, select surgeons in the nation who is trained to perform scoliosis surgery on children as well as adults. Dr. Francis is a fellowship-trained, board-certified spine surgeon and has extensive experience in treating scoliosis.
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Detection & Treatment
EARLY DETECTION-WHAT TO LOOK FOR
Scoliosis is not preventable, but early detection and treatment during the growth years is important in order to control the progression of the curve. Idiopathic scoliosis can easily go unnoticed. Therefore, parents should watch for the following signs of scoliosis starting when a child is about eight years of age:
- One shoulder or hip may appear higher than the other
- One shoulder blade sticks out
- Rip hump at the back of the waist or on the back at the ribs
Dr. Francis is highly experienced in diagnosing the causes of adult spinal deformities and other spinal disorders as well as providing both surgical and non-surgical care. Full -length standing x-rays are essential in the diagnostic evaluation of adolescents with scoliosis. Dr. Francis will measure the x-rays to determine the size of the curve(s), which is measured in degrees using the Cobb method. A straight spine has a curve of 0º, any curve greater than 10º is considered scoliosis. Advanced imaging studies (i.e. MRI or CT myelography) may be needed to assess patients with lower extremity symptoms or other neurologic signs or symptoms.
Curves measuring less than 20° on an x-ray usually do not require treatment. However, observation and repeated examinations may be necessary to determine if the spine is continuing to curve.
Curves between 25° and 45°, or that show rapid progression, may require a brace. This is used to prevent the curve from getting worse until adolescent skeletal growth is complete. Curve progression typically slows down or stops after puberty.
Curves measuring 45° or more, where bracing is not successful in slowing down curve progression, may require surgical intervention. In these instances, surgery has been found to be a highly effective and safe treatment for adolescents.
“Even after years of practice, I still get excited when I see the change in our patients on the first visit after surgical correction.” – Richard R.M. Francis, MD