Scoliosis, a teenager & Simon Cowell (‘X Factor’)

Scoliosis in the young.  How to spot it (The ‘Skyline’ test)

Get your son (or daughter), to stand barefoot in front of you with his back to you.  Ask him to bend over  to touch his toes with knees straight.  Don’t worry if he can’t touch them!  Not everyone can, especially among males.  Get your eyes at the same level as the the highest point of his back.  Is it level or does the left or right side of his back look higher (closer to the ceiling), than the other?  If ‘yes’, then you’ve found one.

You should check again, but this time watching for any ‘hump’ on one side of the spine all the time he/she is actually going down rather than just at the end of the movement.  This is because it might appear more in different areas earlier or later in the bend.

 

Now you think you’ve found one doesn’t mean it’s time to panic!

Curvature of the spine, or scoliosis, is more common in girls, about 1 in 30 will have one. It often runs in families and is only of concern when it gets beyond a certain angle – somewhere around 30 degrees. If it’s below that your doctor will probably just monitor your child a couple of times a year to make sure it’s not increasing.

But if it gets beyond about 30 degrees there are treatment options providing that the spine has not stopped growing. These include a body brace that’s worn night and day, even during exercise. A scoliosis inevitably leads to altered lines of tension or tightness through muscles and joints as the forces around them are no longer symmetrical.  Muscles on the inside of the curve will be shortened compared to the same ones on the outside.  It also causes people to have much easier direction of  movement when it comes to twisting the spine, which is reflected through the ribs.

 
The next step up is usually a spinal fusion to lock the vertebrae in place to prevent them growing any further out of line. This can be done by tethering them to titanium rods running parallel to the spine, but there are other variations too All very effective, but rather extreme for a young spine that’s supposed to bend and flex over a lifetime!  

 

Enter Simon Cowell (X Factor) & the teenager!

And to the rescue of one Julia Carlile, aged 15, auditioning for Britain’s Got Talent. After telling the judges she was entering because she wouldn’t be able to dance again after her upcoming surgery in the U.K., Simon coughed up $148,247 of his own money for a more advanced procedure known as Vertebral Body Tethering (VBT) in the U.S. As you can imagine, this set off a storm of public comment reflecting concerns that the procedures available under the U.K’s National Health Service were inferior or low tech.  

 

How VBT is different

The idea is to allow the spine more flexibility whilst straightening it out.  Imagine some square shaped building blocks lying close together in a curved line on the floor. On the inside of the curve the edges of the blocks will be closer together than along the outside. In the actual spine the inside edges of the vertebrae will be under greater pressure and growing more slowly than on the outer side. That’s just how the biology is.

 
VBT involves inserting screws into the vertebrae (our building blocks) on the side along the outside edge of the curve. Then a cord is attached to the screws and pulled tight. That pulls the outside edges closer together to straighten the curve. But wait; there’s more! Apart from the immediate straightening, there is another benefit. There’s a physiological law that says that there is faster bone growth in areas of lower pressure or stress. So over time those inside vertebral edges, now under less stress, will gain more height than on the side with the cord and screws. That effectively helps to block the spine from resuming its curve. Hey presto!
 

The downside?

VBT has only been around for about 5 years, so it’s not got much of a track record behind it for anyone to say how good it is over the long run. So in a real sense, it’s still experimental. You could say it’s still in the audition phase…

Posted in Children