Scoliosis Awareness Month: how GOSH helps children with Scoliosis

This month is Scoliosis Awareness Month and Mr Ramesh Nadarajah, Consultant Spinal Orthopaedic Surgeon, explains what Scoliosis is and the work GOSH are doing to help children with the condition.

Scoliosis is a curve of the spine which twists and projects to the side and can affect children and adults. It is not as rare as most people think and can affect up to 6-8% of the population. The diagnosis of scoliosis is mostly picked up during childhood and can vary from congenital, postural, early onset or late onset scoliosis.

The severity is based on the size or magnitude of the curve on diagnosis and how it progresses with time. Most spinal surgeons use a simpler terminology of mild, moderate or severe types of scoliosis when discussing with parents or children. As scoliosis gets worse, it can cause several things to occur to the shape of the body and spine for example a rib hump, Loin hump, loin crease, Imbalanced waist line or shoulders, truncal shift and sometimes pain.

Treatment for scoliosis depends on the severity of the curve, how quickly it has progressed and the amount of growth that the child has left. Mild curves are normally monitored on a 6 to 12 monthly period; moderate curves can be braced and again monitored on a 6-monthly period; some moderate and most severe curves are normally treated with spinal surgery which differs depending on the age of the child and the amount of growth left. Spinal surgery can range from growth modulation surgery, which means that the spine can grow using devices such as growing rods, to final fusion which means that the spine is held with screws and rods.

‘The best way to look for scoliosis would be to look for asymmetry affecting either the shoulders, hips or the ribs when bending forward with knees kept straight’ says Mr Ramesh Nadarajah. ‘At GOSH, we have an established research collaboration with the Institute of Child Health which is one of the largest research institutes for paediatric conditions in Europe. Our spinal unit has participated in several spinal research programmes of which the Magnetic Growing Rods was part of it. As a unit providing very complex spinal surgical methods, we are always at the forefront of new and innovative treatments. We hope to look at Vertebral Body Tethering as a method of spinal surgery as part of a multicentre research in the near future.’

Mr Ramesh Nadarajah started his postgraduate training in Neurosurgery and this exposed him to disorders of the spine and brain. His area of interest is spinal disorders and he trained further within the field of Orthopaedic surgery. This allowed him to treat both children and adults with bone and nerve related problems within the spinal column. ‘I enjoy the team-based approach of working in GOSH in managing children with very complex spinal disorders.’