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Early detection key in treating children with curved spines

By Deangelo McDaniel
dmcdaniel@decaturdaily.com · 340-2469

HARTSELLE — To look at Dakota Goff, you'd never know that underneath her skin is a spine that winds like a country road.

She's an active girl and prefers to jump and tumble with her friends and dog than to sit at home with the body brace she has to wear.

Unlike the majority of her classmates at Barkley Bridge Elementary, Goff, 10, suffers from scoliosis, a condition where the spine curves side to side.

When detected during a routine physical examination two years ago, her spine looked like an "S" and curved 24 degrees at the base of her neck.

"I thought 'Oh my God, I'm not going to be able to cheer,' " she recalled.

As with 80 percent of scoliosis cases, doctors don't know what caused Goff's condition.

Fortunately, though, 90 percent of scoliosis cases are mild and are treatable, said Tiffany Jackson of the Scoliosis Research Society in Milwaukee.

"If scoliosis is detected in a growing adolescent, it's very important that the curves are monitored for change with regular physician checkups," she said.

One of the keys to treating scoliosis is early detection, Jackson said. That's why since 1984, Alabama schools have tested fifth- through nine-graders annually.

"It's a simple test and doesn't take a long time," Barkley Bridge registered nurse Karen Bynum said.

Bynum said few students have scoliosis, but if it is detected, schools in Alabama are required to notify the student's family physician.

She said scoliosis is painless in the beginning because the curvature does not happen overnight.

The danger of not treating scoliosis is that the spine can rotate and puncture a lung or put pressure on the heart, Bynum said.

"Early detection is important," she said. "We try to prevent it from getting to a point that a student may need surgery."

West Morgan teacher Melanie Henson knows the importance of early detection and how painful scoliosis can be. But, she's also an example that people with severe scoliosis can have active lives.

"Doctors initially thought I had a touch of spina bifida because I had a thin sheet of skin over a spot on my back," Henson said.

By the time she was a fifth-grader at West Morgan Elementary, Henson had a 20-degree curve. During her next examination less than a year later, the curve had increased to 44 degrees.

23 hours a day in brace

She wore a back brace 23 hours a day for six months.

"It's tough enough being in middle school, and it was horrible having a brace on you in the sixth grade," Henson recalled.

She outgrew the brace and refused to wear another one. Henson told her mother and doctors she would deal with the consequences of not wearing a brace.

At age 16 in 1989, she was a cheerleader and played volleyball, basketball and softball for West Morgan.

At Children's Hospital in Birmingham in February 1989, doctors found bone fragments in her spinal column. One month later, Henson had an eight-hour surgery. Her hospital stay was nine days, and during that time, she realized the severity of her scoliosis.

Henson walks with a limp because her scoliosis starts in her pelvic area and goes to her lower lumbar.

One of her hips is higher. She said her internal organs are not where they are supposed to be.

"Everything has shifted," she said.

Now 34 and the mother of two, Henson remembers the day doctors at a Georgia sports clinic wanted to insert four metal rods down both sides of her back and connect them with another rod in her pelvic area.

"I was very active at the time and wasn't having any pain," she said. "I told them no, and my parents agreed."

Henson supports scoliosis screening but said parents should also check their children.

'Very visual'

"It's very visual," she said about scoliosis. "I check my children all the time because it may not show up until they hit a growth spurt."

After graduating from Athens State in 1995, Henson worked three years at a nursing home. She said she was surprised at how many elderly residents were diagnosed with scoliosis for the first time.

The American Academy of Orthopaedic Surgeons recommends that girls get scoliosis screenings at ages 11 and 13 and boys at ages 13 and 14. Parents who have dealt with it recommend earlier screenings.

If Goff had not wanted to be a youth football cheerleader, her scoliosis might not have been detected until she reached the fifth grade.

"She was getting a sports physical when the doctor found that she had scoliosis," said her mother, Maxine Goff. "We thought it might be a small curve until they did an X-ray at Children's Hospital."

Dakota Goff has been wearing a brace for almost two years. The first brace she wore 23 hours a day, and after a growth spurt, the curve declined from 24 degrees to 14 degrees.

The rib hump, a condition where one side of the back is higher when Goff bends forward at the waist, disappeared.

Her mother, almost emotional, said, "It used to be very noticeable."

She knows what scoliosis can do to the body if not detected early and treated. Maxine Goff has a 62-year-old aunt who is in considerable pain because her scoliosis was not detected until adulthood.

"Her heart has been pushed more to the opposite side of her chest cavity than normal by the rotation of the spine and rib cage," the mother said.

She said her aunt's lung capacity declined and her carotid arteries in her neck are twisted.

"She's in a lot of pain," Maxine Goff said.

As for her daughter, she continues to cheer and wears a brace in bed at night, a brace she may wear throughout her teenage years.

Without shame

"But that's OK because I'm not nervous anymore, and I'm not ashamed of telling people I have it," Dakota Goff said.

Scoliosis Awareness Week is March 4-10.

"I hope parents take the time to check their children," Maxine Goff said. "It's never too soon to start looking."

What is scoliosis?

n Scoliosis is a sideways curving of the spine.

n One in 10 people will have scoliosis. Two to three in every 1,000 will need active treatment for a progressive condition. In one out of every 1,000 cases, surgery may be necessary.

n Frequent signs are a prominent shoulder blade, uneven hip and shoulder levels, unequal distance between arms and body, and clothes that do not “hang right.”

n Eighty percent of scoliosis cases are idiopathic (causes unknown). Scoliosis tends to run in families and affects more girls than boys.

n Spinal curvature is best dealt with when a young person’s body is growing and can respond to treatments, such as a body brace. Mild cases may not need treatment but must be monitored.

n Kyphosis (round back) may also occur in developing adolescents. It should be screened for and may require treatment.

n You, your physician and/or your school-screening program can perform a 30-second annual screen during growing years. An annual screening for scoliosis and kyphosis during bone-growing years can make the difference between a preventable condition and a disability in adult years.

Source: National Scoliosis Foundation

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