BUILD BACKS BETTER

In a scoliosis market where treatments have changed little since the 1970s, even new brace technology shows how far we still have to go

- Amanda Kolson Hurley

AT THE END OF MY SON’S ANNUAL CHECKUP LAST YEAR, the pediatrician called me back into the exam room, where my 15-year-old had his shirt off and his back to me. He’d asked my son to bend toward the floor, his spine standing out in a knobby ridge. “See that?” the doctor asked. I did: My son’s back was askew, the ribs slightly higher on the right side than on the left. I didn’t have to ask what it meant. I remember taking—and failing—the same test myself, decades ago.

Scoliosis, a curvature of the spine in a C or S shape, runs in my family. The condition affects 2% to 3% of the population around the world. Usually appearing around puberty, it’s much more likely to become severe for girls than for boys. (In this article, I use the term scoliosis as shorthand for adolescent idiopathic scoliosis, or AIS, by far the most common form of the condition.) Doctors don’t know exactly what causes AIS. There’s often a genetic component, but how it gets passed down is unpredictable. It can skip generations, and it might affect one child in a family but none of her siblings.

Tens of thousands of children and teenagers will be diagnosed with scoliosis this year in the US alone. When the curvature is mild, in most cases it won’t worsen significantly and no treatment is required, only observation. If it’s more pronounced, doctors usually prescribe a back brace to stop the curve from progressing. Severe scoliosis left untreated leads to an off-kilter spine and ribs that squeeze the lungs, often resulting in chronic pain and restricted breathing. When a back brace doesn’t work, the next step is surgery.