Juvenile scoliosis is scoliosis diagnosed in children between the ages of 4 and 10 years old. Statistics show that curves detected in the younger years translates to increased risk of progression. According to the SRS website, 95% of juvenile scoliosis cases will eventually undergo surgery while another study cites 70% will progress to the point of surgery.
The S3DC program for juvenile scoliosis offers families the opportunity to take a proactive approach at a time when the current medical model may recommend ‘watch and wait.’
Schroth Method for Juvenile Scoliosis
No matter the degree of the curvature, treatment for juvenile scoliosis usually begins with instruction in the simplest components of our Schroth program. This includes teaching the child daily postural modifications (ADLs) that are easy to learn and/or physiologic® exercises for the sagittal plane. When applicable, we also teach mobilization exercises (active, passive and active-resisted) to do at home with mom and dad. Our methodology is designed to address developing curve(s) and noticeable spinal imbalances and asymmetries (for example, shoulder unleveling, hip prominence, etc.).
Unfortunately, some juvenile scoliosis patients are not yet candidates for our complete Schroth program. Young children often lack the attention and ability to understand Schroth rotational breathing concepts, however, we gauge this on an individual basis. The process usually begins with shorter sessions and more prolonged treatment intervals than for adolescents, and that’s okay! When your child is our patient, we will closely monitor their progress. Depending on curve severity and individual factors, we will begin to add Schroth breathing concepts and exercises as physical and intellectual development occurs.
Scoliosis Brace for Juvenile Scoliosis
When Cobb angle exceeds 20º, it’s a time for heightened vigilance for parents of children with juvenile scoliosis. Whether or not bracing is recommended will also depend on a combination of factors other than Cobb angle. These include age, stage of development, existing postural imbalances, and family history. As the 25º mark approaches, a bracing recommendation is more likely.
For curves at or exceeding 25º, we typically recommend immediate bracing with the Chêneau-Gensingen brace in order to try to make improvements and stay ahead of the curve through growth. At this point, continuing to watch and wait and failing to take proactive steps is not in a child’s best interest according to the current literature and statistics on juvenile scoliosis. By taking the appropriate action, parents can use their child’s remaining growth as an opportunity for correction rather than something to fear.
Our approach to bracing juvenile scoliosis is to take advantage of growth to remodel the spine. The Chêneau-Gensingen brace uses strategic pressure points to target scoliosis curves and voids to replicate Schroth breathing during brace wear. This Schroth compatible brace differs significantly from the Boston brace, the Charleston brace, or the Providence brace in that it is a 3D asymmetric brace with the goal of overcorrection.
With scoliosis, there are a couple advantages to beginning bracing early. One is that younger children, as a rule, are more likely to have flexible spines. This makes the spine more amenable to bracing and increases the likelihood of a good in-brace correction. In-brace correction is important for reducing asymmetrical spinal loading during growth so that the spine can grow properly.
For patients that get overcorrection in-brace (spine moves past the middle to the opposite side), there is a greater opportunity for net correction out-of-brace. Another advantage to bracing early is that our younger patients often seem more eager to please and are cooperative with brace wear compared to those first braced in adolescence.
At Scoliosis 3DC, we accept juvenile patients on a case by case basis. If you have interest in learning more, please contact us.