Staying Ahead of the Curve
State-of-the-art care in the community builds on recent advances
At the Emerson Scoliosis Program, patients receive the most current approach to care, beginning with a careful assessment to determine the most appropriate steps. Experienced team members will assess and monitor your child. If the spine’s curvature is great enough, the team will collaborate and design a treatment plan. Communication with the patient’s pediatrician leads to enhanced continuity of care and is the cornerstone for success.
Scoliosis is a condition where the spine grows in a rotational and sideways manner. It can be mild and remain stable, but it also can increase over time. Most patients will be referred by their pediatrician or school to a scoliosis clinic when the reading on a forward-bending test is approximately 5-7 degrees. Treatment typically is started if the degree of the child’s curve, as measured by an x-ray, has progressed to 20-25 degrees.
The goal of treatment is to prevent scoliosis from progressing and, ultimately, to diminish the curve. Today’s approach to treatment combines the use of sophisticated, customized bracing with specialized, rigorous physical therapy that is specific to scoliosis, known as the Schroth Method.
The Emerson Scoliosis Program, directed by John Cahoy, MD, PhD, pediatric orthopedic surgeon, and Mary Evans, PT, DPT, MS, located at Emerson’s Westford Health Center, combines the key elements that lead to treatment success.
Treatment for scoliosis is evolving
A large study published in 2014 made it clear that bracing — having the child wear a specialized, custom brace for much of the day — can prevent scoliosis from progressing and significantly reduces the chance that a patient will require surgery. This has convinced specialists that bracing is an essential part of treatment.
Although there are many established braces in use, the Emerson Scoliosis Program mainly uses the Wood Cheneau Rigo (WCR) brace, which builds on many decades of advances and has proven itself over two decades of use in Europe. In addition to being customized to the patient and relatively lightweight, it provides 20 pressure points that address the side-bending and the rotational component. Our orthotic staff are also experienced at making other types of braces, such as the Boston Brace, giving patients multiple options from which to choose.
Health plans typically cover the costs associated with bracing, although there is usually a required co-payment. The Emerson Scoliosis Program welcomes patients who are already using another type of brace.
In summary, the WCR brace and Schroth PT represent the most current approach to treating scoliosis.
A team with deep expertise — under one roof
The Emerson Scoliosis Program brings together a team who are experienced and committed to providing the most effective care for scoliosis.
They include John Cahoy, MD, PhD, who is fellowship-trained in pediatric orthopedic surgery, who oversees the program and examines patients on a regular basis; Mary Evans, DPT, PT, a pediatric and neurologic clinical specialist who is certified in Schroth PT; and orthotists from Bay Orthopedic, who fit patients for their braces and make ongoing adjustments during the course of treatment.
The collaborative approach extends to the patient’s pediatrician, who is often involved in the initial diagnosis of scoliosis. Pediatricians receive treatment notes and summaries so that they are well aware of the plan of care. In children with mild curves who do not require bracing, routine follow-up — repeating the forward-bending test without x-rays — often is done during alternating visits with the pediatrician.
The program’s location in Westford brings everything patients need under one roof. Emerson uses all digital x-ray technology at Westford and Concord, which means that patients are exposed to less radiation. The team’s goal is to reduce the number of x-rays taken over the course of treatment.
What is Schroth physical therapy?
The Schroth Method or Schroth PT was developed specifically for individuals with scoliosis. It consists of a series of exercises designed to strengthen the muscles around the spine, which are less developed in those with scoliosis. It works with the WCR brace, which was designed utilizing Schroth principles. Patients are instructed to perform certain exercises while wearing the brace.
Education is built into Schroth PT. Patients learn about their specific curve and how treatment — bracing and Schroth PT — can counteract the curve. The patient learns the exercises, which they perform at home, and integrates Schroth PT into their lives through an awareness of maintaining the correct posture.
- Because pediatricians screen children for scoliosis, they are often the ones who detect it, along with parents, gym teachers and school nurses.
- It is most commonly diagnosed in children age 10 to 12 and in the early teens.
- Scoliosis is found in approximately 3 percent of the population, more often in girls.
- Although scoliosis can run in families, more than half of all children diagnosed with scoliosis do not have a family history.
- Less common types of scoliosis include juvenile scoliosis and scoliosis caused by cerebral palsy, muscular dystrophy, birth defects and spine injuries or infections.
- It is important that patients receive treatment during rapid growth (11-14 for girls, 13-18 for boys). Treatment continues until the child or teenager has stopped growing.
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