Scoliosis, an abnormal curvature of the spine, can vary from mild to severe. But even mild cases can worsen over time and cause problems with posture, pain, and breathing. Duke pediatric spine specialists offer the full range of nonsurgical options -- including bracing and specialized physical therapy -- as well as the latest advances in spine surgeries and procedures. We tailor our treatment recommendations to each child's unique anatomy and needs and follow them through adulthood.

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About Scoliosis

Your child’s personalized treatment plan will consider the underlying cause and severity of their scoliosis as well as how much your child will grow. The most common types of scoliosis are:

Idiopathic Scoliosis (Infant, Juvenile, and Adolescent)
The cause of this most common type of scoliosis is unknown. It is characterized by a side-to-side curve (usually in a “C” or “S” shape) in the spine and a “rib hump” (when one side of the rib cage sticks out more than the other). 

Neuromuscular Scoliosis
A spinal deformity occurring in children with neuromuscular diseases such as cerebral palsy, spina bifida, or muscular dystrophy.

Congenital Scoliosis
Misshapen vertebrae present at birth that cause the spine to curve, which worsens with age.

Our Locations

Duke Health offers locations throughout the Triangle. Find one near you.

Nonsurgical Options for Scoliosis

Physical Therapy

A specialized physical therapy approach called the Schroth method uses specific exercises to shift the spine into a more natural position. In addition, if scoliosis has not caused severe curving of the spine, physical therapy can help strengthen your child's back and improve balance and flexibility. This helps minimize pain and avoid injury.

Bracing

Especially in children with moderate to severe spinal curves who have plenty of growing left to do, wearing a custom, removable back brace can keep scoliosis from getting worse and can help your child avoid surgery.

Casting

Particularly for very young children and infants, a cast surrounding the torso can help correct scoliosis.

Scoliosis Surgery

For most traditional scoliosis surgeries, your child will receive general anesthesia and will stay in the hospital for a few days to recover. Your child may also need physical therapy. Depending on the procedure, kids can usually return to school after one to six weeks. Not everyone is a candidate for every procedure. Your child’s surgeon will explain which options may be best for your child.

Spinal Fusion
Spinal fusion surgery is considered the gold standard in scoliosis treatment for children. Surgeons use screws and rods to straighten the curve in the spine and provide a more normal alignment. Along with the screws and rods, a bone graft is added to stabilize that portion of the spine and prevent curve progression. Our specialized operating room teams use the most advanced and safest techniques available, including robotic and CT-guided surgery, to help your child recover quicker and experience less pain and fewer complications. 

Spine Osteotomies
For severe cases of scoliosis, surgeons cut or remove some of the bone in the spine to correct alignment. This is typically performed along with a spinal fusion surgery. 

Vertebral Body Tethering
During this minimally invasive procedure, surgeons access the spine through several small incisions from the front of the spine. A special rope is attached across several vertebrae and pulled tight. The tension from the tether guides future growth, helping the spine to straighten over time. Compared to spinal fusion surgery, vertebral body tethering may allow your child to maintain a better range of motion. 

Shilla Growth Procedure
This technique is best for children with a severe curve and who still have a lot of growing to do. The Shilla procedure fuses a short portion of the spine, and rods are placed above and below the curve to help correct it. The rods are able to slide, allowing the spine, chest, and lungs to grow with the child. Follow-up surgeries may be needed to remove or replace the system when the child is done growing. 

MAGEC Growing Rods
MAGEC (MAGnetic Expansion Control) rods are an option for young children who may require multiple surgeries as they age. Unlike traditional expandable spinal implants that must be surgically lengthened every six months, the MAGEC device is lengthened using an external magnetic motor placed on the child’s back. The noninvasive lengthening procedure, which can be done in a doctor’s office, is repeated every three to six months for about three years. Like the Shilla growth procedure, additional surgeries may be needed to remove or replace the system once the child is fully grown.

Tests

Traditional X-Ray

X-ray imaging is the best way to identify scoliosis. This test shows joints and bones in your child’s back so a doctor can measure the degree of spine curvature to determine severity. It takes a few minutes and is painless and noninvasive. Because X-rays only show bones, and not discs or nerves, an additional imaging test might also be needed.

EOS X-Ray

This specialized X-ray is a great option for kids because it uses significantly less radiation than traditional X-rays. The entire body can be imaged at once, from both the front and side, and it can be done while your child stands up. 

MRI or CT Scans

These scans create more detailed, 3D images of the spine, including the discs, nerves, and spinal cord. They may help determine whether surgery is necessary. MRIs and CT scans take about 30 to 60 minutes and are virtually painless.

Best Children's Hospital in NC

Duke Children's Hospital & Health Center is proud to be nationally ranked in 10 pediatric specialties.

Why Choose Duke

Highly Experienced Spine Center
Research shows that hospitals and surgeons who perform more surgeries tend to have better outcomes. Our surgical team performs more than 3,000 spine surgeries every year and sees over 30,000 patients.

Latest Surgical Techniques
Our skilled spine surgeons regularly perform complex procedures using the latest techniques. Duke is one of only a few centers in the region offering the Shilla growth procedure and vertebral body tethering. Intraoperative imaging like CT-guided navigation and robotic surgery helps us perform scoliosis surgery with added precision.

Low-Radiation Imaging 
Duke uses the EOS imaging system whenever possible, which limits your child’s exposure to radiation. This is especially helpful for children with scoliosis, who may need periodic X-rays for years.

Team of Specialists
Our spine experts have advanced training and experience in diagnosing and treating many types of scoliosis. Your child's care team may include pediatric neurosurgeons and orthopaedic surgeons, pediatricians, anesthesiologists, neurologists, pulmonologists, physical therapists, and many others. We have a dedicated pediatric intensive care unit that caters exclusively to children, child life specialists who can help kids understand what to expect during treatment, and a support staff to help them recover and rehabilitate quickly and safely.

Committed to Advancing Scoliosis Care
As members of the Scoliosis Research Society, our spine surgeons stay up to date on the latest scientific findings and treatment options. We may be able to offer your child the opportunity to participate in clinical trials that are exploring ways to improve mobility and shorten recovery time following surgery.

This page was medically reviewed on 08/19/2022 by