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23rd January 2007, 12:38 PM
Hello to everyone,
My son, aged 9, has had a lumbar spine xray, which has shown a slight curve. We have an appointment with a consultant from Orthorpaedics on the 31st January.
I am very new to curves and scoliosis, so please forgive my ignorance, I was wondering if a slight curve is definately scoliosis, or if there is something else it may be, or if some people natuarally have slight curves?
If anyone has suggestions of questions I should ask when we see the consultant, I would be very grateful, as I am a bit worried that I may miss something that is important or useful to know.
23rd January 2007, 01:22 PM
I'm sorry you're having to go through such stress and worry, but nevertheless :welcome2: We'll do all we can to help and support you :-)
Generally speaking, if a curve measures less than 10°, it is not considered to be scoliosis. However, in a child who has not yet stopped growing, or even an older teenager who may not quite have stopped growing yet, even a curve this small will need to be monitored to see if it changes or increases.
It's definitely true that a lot of people have small curves and never suffer any problem from them, but it is very unpredictable whether any individual curve will remain small. Generally speaking, curves which are no bigger than about 40 degrees when growth has finished will not progress, but curves bigger than 40-50 degrees are likely to continue to progress slowly over the years even after growth has finished.
The main aim of treatment therefore is to monitor for progression or change, and if there is any (or the curve is large enough when first discovered) to treat it eg with bracing, to prevent further progression and keep it small enough that surgery will hopefully not be required.
Two questions you definitely need to ask the consultant are what the actual size of the curve(s) are, and what your son's Risser sign is. The Risser sign is a way of measuring skeletal maturity, and is a number from 0 to 5. The lower the number, the lower the skeletal maturity and I would expect because he is so young that your son's Risser will be low - even so it is worth knowing as it gives something of a baseline. As it is determined by the appearance of part of the pelvis, it should probably be visible and measurable on the xray that has already been taken (it's likely the consultant will want to take new xrays anyway though).
Something to bear in mind about xrays is that they should be done while standing, and ideally the whole spine should be imaged either as a single film, or if the hospital does not have the facilities to do single full length films, this can be worked around by taking 2 xrays with a minimal overlap. The consultant may also want to do a side view xray, as sometimes scoliosis curves go hand in hand with either too big, or too small, lordosis and kyphosis (the natural curves everyone has when their spine is viewed from the side), so don't be surprised if 2 different types of xrays are taken.
I'd also expect that unless there is no curvature at all on the xrays (assuming that more are taken), the consultant will likely want you to return and to take another set of xrays and be evaluated again in about 3-4 months, as this will allow them to see if there has been any change. Depending on the size, shape and location of the curves, there is a small chance that the consultant will also want to refer him for a MRI as this can be a useful diagnostic procedure. There's no need to worry if this isn't done, or even if it is - it's partly down to the preference of the consultant, most don't do it but some always do for younger children - it's just one of those things, but I just thought I would mention it in case it is suggested and worries you.
Hope this helps a bit! And I'll keep my fingers crossed that all is well and your son does not need anything more than occasional monitoring :-)
23rd January 2007, 01:46 PM
Many thanks for that information, didn't know what the Risser sign was. It is extremely nice to know what sort of thing to expect at the consultation, it can be quite scary epescially for a 9 year old, it will help him to know what might happen and why.
It came as a surpirse to me that he even had a curve, it was picked up by a private GP we saw as my son had pain in his ribs, normal doctors did not find anything wrong, just said that the ribs may be inflammed and recommended painkillers, private GP done lots of tests, found out that he has 2 viruses (HHV6 and mycroplasmic puenmonia) done the forward bend test, and suggested to have an xray done as one of his shoulder blades was slightly raised.
Thanks again for the info. 8)
23rd January 2007, 03:28 PM
Hi there, just wanted to say :welcome:
It must have come as a shock to find your son has a curve, but I think it's lucky that it's been picked up so early.
Mine wasn't picked up until I was about 14 but I know I had it long before then as my ribs, hips and waist were uneven, I just didn't know why.
There seems to be much more careful monitoring and treatment available for scoliosis now than when I was a youngster (I'm 49 now), so your son should be in good hands whatever the outcome.
There's a wealth of knowledge available on this site, I seem to learn something new nearly every day (especially from Titch :-) ), so you don't need to go through this without support.
Keep us informed and good luck at your next appointment.
23rd January 2007, 03:48 PM
Helo welcome to SSO
You also need to take a pen and note pad with you so you don't miss anything he says
I hope you find the site as supportive as i do.
23rd January 2007, 04:18 PM
Thanks for making us feel very welcome.
I have just read all the replies to my son, the info and support you have given have made him feel better about going to see the consultant. :rox:
I have told him that he can ask any questions, and if I dont know then we will ask on here.
23rd January 2007, 05:13 PM
I would like to add that my father lives an amazingly active life with a small curve (currently 71 yrs old). My grandmother lived a very full life with a curve that was larger than his. My husband (45) has a small curve and plays golf every year, fishes for hours, builds walls, additions and furniture, as well as wrestling with his son. His mother lives with a small curve and she's very active at 75 years young. I have a larger, but compensating curve in my spine (one shoulder doesn't appear lower than the other). My curve is more extreme, so I was prescribed a Milwaukee brace to wear. My point is that people all around us are living with small curves and (unless they become obese) will never realize any side-effects from that small curve.
Remember that as the two of you go back for your follow-up check-ups. Good luck with this.
23rd January 2007, 05:18 PM
Hi, just wanted to say welcome to Sso!
Just wondering where youre from and the hospital/consultant you're seeing, you never know, someone on here could have the consultant as your son !
Hope you get all the help you need on here, its a great place to be!
23rd January 2007, 05:50 PM
First - Welcome to SSO. Lots of great info here and more support than anywhere else on the planet. Try not to panic but instead congratulate yourself for being on top the situation. You are your son's best advocate. It is a great idea to keep a notebook. Your son can keep one too. Keep track of questions and it doesn't hurt to write down the answers at the doctors office. Try to get copies of all xrays etc. - you wouldn't beleive how easily those kind of things can get lost at clinics etc.
23rd January 2007, 08:23 PM
:welcome2: I hope you like it here and we can help you out! Good luck with the appointment! :squeeze:
23rd January 2007, 09:17 PM
Hi I'm new to the forum too but have found it so helpful and have had some questions answered. My daughter is only 3 and we have had one appt. with the consultant and she has had a ct scan and an mri. We are going for another appt in March for more x rays to compare the curve and to discuss what we are going to do. I'd agree with everybody to keep a notebook with questions as I always forget 1 thing! We are finding the waiting the worst thing at the minute as we have been told that she will need surgery but not a lot else!
Keep us updated on the progress
23rd January 2007, 09:47 PM
My consultant is getting so used to seeing my little purple notebook now that he rolls his eyes when I get it out of my bag! :P
I'm currently filling it with questions ready for my 6 month post-op appointment in March. I jot down the gist of what I want to ask him to remind me and then leave a few lines to write in his answer, otherwise I'd already have forgotten it by the time I get home. (It's an age thing!) ;-)
I love the idea of also letting your son think of some questions, giving him ownership of the situation will make him a whole lot more confident.
23rd January 2007, 11:41 PM
My daughter had about a 9 degree idiopathic curve at 10 years of age. They just had her back in six months for a visit, and it hadn't done anything, and they followed up one more time, and then released her since no changes at all. The doc said it wasn't bad enough to be scoliosis, more a natural curve for her as many people's spines aren't perfectly straight. I hope your son has a similar experience and his curve doesn't get any larger! Fingers crossed for your visit!
My other son Billy had congenital scoliosis from spine malformations, and his progressed to 48 degrees by six and a half, so he had a fusion from T11 to the bottom. Totally different scenario with malformed bones, not much you can do other than watch it and wait and see what happens. If your son progresses and his scoli is idiopathic, they can brace it to help things, although hoping it doesn't get to that point.
25th January 2007, 10:12 AM
Hi there. I'm rather late to welcome you I'm afraid (I've only been away for a day or two!). Welcome to SSO. You've been given loads of advice, so I won't repeat any of it. Just wanted to say lots of luck for your appointment next week. Let us know how it goes.
26th January 2007, 10:03 AM
Thanks to all that have welcomed us, sorry I have not replied earlier, some days I do not get the chance to go on the computer.
It is great to know that you can keep active with a small curve, as my son, Zachary, is very active (football, motorbike, golf etc), I was wondering if his curve would affect the things he does, but from reading on here it seems like keeping active is a good thing.
We live just outside of Guildford, Surrey (UK), and have been referred to Mr Paremain at the Royal Surrey County Hospital, Orthopaedic Clinic. I have no idea of how good they are with Scoliosis.
I will definately take a notebook, I have a head like a sieve. I will let everyone know how we get on at our appointment next week, many thanks for all the kind wishes they are very much appreciated. :squeeze:
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