Comprehensive Approach to Scoliosis Care

Scoliosis is an abnormal sideways curvature of the spine, primarily affecting adolescents.

In the United States, an estimated nine million people have scoliosis. While scoliosis can be caused by congenital or neuromuscular conditions, most of the time it is idiopathic, meaning the cause is unknown.

Many keiki (children) with scoliosis often don’t realize they have it until someone notices their unusual posture, such as a visible curve in their back, asymmetrical shoulders or hips, an uneven waist, or ribs that stick out more on one side versus the other. Left untreated, scoliosis can worsen as the curve of the spine increases, resulting in back pain or stiffness, fatigue or even breathing problems. For this reason, the spine team at Shriners Children’s Hawaii is committed to proper treatment during adolescence, as keiki have not yet reached skeletal maturity. With proper bracing and education, further curvature of the spine can be reduced or prevented, helping minimize the potential for surgery and months of rehabilitation.

“When it comes to scoliosis, the devil really is in the details”, said pediatric orthopedic surgeon Paul Moroz, M.D. “Many factors determine whether an individual patient's scoliosis will worsen causing major problems, or will not progress and cause no problems. Age, gender, growth in height, size of the initial spinal deformity and type of curve are all factors that really need guidance and expertise to figure out,” said Dr. Moroz. Fortunately, Shriners Children’s Hawaii utilizes a multidisciplinary team of surgeons, nurses and nurse practitioners, orthotists, physical therapists and dieticians whose collective expertise provides comprehensive scoliosis care to keiki.

One method used to educate and support keiki and their families is the annual Scoliosis Information Night for Teens and Parents, held in June. The in-person and virtual event was attended by dozens of patients and families, with presentations by the Spine Team as well as testimonials from current and former Shriners Children's scoliosis patients. A highlight of the evening occurred when they shared their care journeys and provided tips on how they successfully managed scoliosis.

“I was a little choked up with emotion and immensely proud of these kids”, said Vena Joco, APRN, who has directly cared for many of these keiki herself. “I am so impressed with how they have persevered and achieved their dreams,” she said.

One example was Kahiau, a former Shriners Children's patient who shared the challenges of scoliosis, and who will be attending Georgetown University School of Medicine this fall. “When I was a Shriners patient, I wore a back brace for two years and I dreamed of becoming an orthopedic surgeon,” he said. “Since I was 13, Shriners really cared about me and always addressed my concerns. I learned that medicine is a two-way street, and that Shriners is very patient-centered, allowing me to feel heard and well cared for.”