Scoliosis and Spinal Treatment: Hudson Valley Curvy Girls Support Group for Young Women with Scoliosis

Watch your back: New treatments for scoliosis are gaining ground

Photograph courtesy of Rachel Voorhees

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Twenty-year-old Rachel Voorhees of Walden remembers the moment seven years ago when she first learned she had scoliosis — a muscular imbalance in the back which causes the spine to contort into abnormal curves. “I was really ashamed,” she says. “I thought it was this weird thing that no one else had.”

But Voorhees is not alone: Two to three percent of Americans (close to six million people) suffer from this disorder. “Many people have subtle curves in their back, but it’s only considered scoliosis when it measures above 10 degrees,” explains Dr. Nicholas Renaldo, a spine surgeon at Orthopedic Associates in Poughkeepsie. Scoliosis — which often manifests visually with uneven shoulders, occasional back pain, humps on the back, or protruding ribs — affects people in all stages of life, but is most commonly seen in children, generally girls, approaching puberty. The cause is unknown, though genetics may play a part.

Roughly 10 percent of adolescents have some degree of scoliosis, but less than one percent of those cases wind up needing treatment. Says Renaldo, “We usually don’t do anything until it grows to 30 degrees or more.”

The most common first treatment for this condition is fitting the patient with a back brace; this does not correct the curve, but rather stops it from getting worse. The idea is for the patient to wear it until he or she finishes growing, at which point the curve will stop growing, too. “When the kid grows fastest is when the curve grows fastest, so wearing the brace at this point prevents it from getting bigger,” Renaldo explains. But such a contraption — which some patients must wear for 23 hours a day — can be taxing, both physically and socially. (Judy Blume famously documented these struggles in her 1973 young adult novel Deenie.) Voorhees, who wore a brace for a year and a half, remembers the difficulties she had. “It felt like it was squeezing me all the time. And I had to get bigger clothes to fit over it, which was tough because at that age, your appearance is a big deal.”

“I was really ashamed,” says Voorhees. “I thought it was this weird thing that no one else had”

If bracing proves unhelpful and the curve reaches 40-45 degrees, most doctors recommend surgery. “Once you hit that number, you risk the curve growing about a degree a year into adulthood,” says Renaldo. “When it hits 60 or 70 degrees it can put pressure on the heart and lungs, and that’s life-threatening.”

In the past, the standard surgical procedure involved placing hooks at the top and bottom of the spine and connecting them to rods to straighten the curve. This invasive procedure usually had a long and strenuous recovery time.

But during the last 15 years a less-invasive method has become more widely used. Renaldo explains that, instead of hooks, special screws are used as “anchor points that are put into each bone. Once you have these throughout the spine you can manipulate it in the proper direction.” Patients are usually walking again within three days, and only need to stay in the hospital for six.

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