164 chapter 20
Body jackets or bracing for a non-fixed
curve usually do not help to correct the
curve or even to prevent its getting worse.
However, for a child with a curve so severe
that it makes sitting or walking difficult, a
body jacket or corset may help.
Instructions
for making
body jackets
are on p. 558.
Spinal curves under 20° (fixed or non-fixed) usually need no special care—other than
to be watched, and measured every few months to see if they are getting worse.
Some experts say that exercises to
strengthen the back muscles, like this, help
correct and slow down the curving of the
spine. Other experts say it does no good.
(We do not know.)
Spinal curves over 20°, if they are fixed and getting worse, may
get worse less quickly with a brace.
A brace like this (the
Milwaukee brace) is often
used. It works because it is
so uncomfortable that the
child must stretch his body as
straight as possible to reduce
the discomfort.
A plastic ‘Boston
brace’ like this is more
comfortable, can be
completely hidden
under the clothes, and
probably does as much
good.
SURGERY
For spinal curves over 50° which are quickly getting worse, surgery may be needed.
Surgery ‘fuses’ (joins together) the most affected vertebrae. Usually it only partly
straightens the spine. Except for very severe curves, surgery should be avoided in
children under 12 years old because the fused part of the spine will not grow any more.
If the curve of the spine is less than 40° by the time the child stops growing, usually it
will not progress further. If the curve is over 50°, it is likely to keep getting worse even
after the child stops growing, and surgery is often recommended.
However, ‘spinal fusion’ surgery is very costly and requires an orthopedic surgeon
specially trained in this operation. It can also be very hard on the child and family.
When surgery cannot be obtained, a body jacket or brace should perhaps be used to
help slow down the curve’s progress. When a curve becomes too severe, there is no
longer enough room in the chest for the lungs and heart to work well, and the child
may get pneumonia and die.
EXERCISES FOR ROUNDED BACK AND SWAYBACK
Children with rounded back may benefit
from exercises to help straighten it,
like this.
These exercises
are explained
in the Exercise
Sheet #5, p. 387.
Children with swayback may benefit
from exercises to strengthen the
stomach muscles, like this,
The child should also be encouraged
to sit and stand as straight as
possible, with the shoulders back.
or by exercises to correct hip
contractures (if the child has them).
See Exercise Sheet #3, p. 385.
Disabled village Children