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Spine Center

The spine specialists at Akron Children’s are using innovative technologies and techniques to advance care for children and adolescents with abnormal curvature of the spine (scoliosis and kyphosis), as well as other spinal conditions. We were the first hospital in Northeast Ohio to obtain an EOS Ultra Low Dose 2D/3D Imaging System, which allows higher quality imaging of spinal deformities, while limiting your child’s exposure to radiation. We’ve also implemented best practices and enhanced care coordination for scoliosis surgery to improve your child’s recovery time and shorten their hospital stay.

The most common spinal problem affecting children and teens is idiopathic scoliosis where the exact cause of the curved spine is unknown. In rarer cases, pediatric scoliosis is congenital, meaning the spinal deformity develops before the child is born. Another form is neuromuscular scoliosis, which can occur in children who have medical conditions that affect their ability to control the muscles that support their back and spine. Akron Children’s offers both surgical and non-surgical treatment solutions for pediatric and adolescent scoliosis based on your child’s curvature and age.

Because scoliosis surgery stops the growth of the spine and can also interfere with the growth of the chest cavity, it is typically only performed on children who are going through puberty and are near the end of growth.

If your child is too young to undergo scoliosis surgery, we have several treatment options that allow us to prevent or delay the need for surgery.

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Locations

Contact Spine Center

330-543-3500

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Orthopedics
Akron Children's Hospital Orthopedics, Akron
Considine Professional Building
215 West Bowery Street
Suite 7200
Akron, Ohio 44308
Fax: 330-543-5001
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Our Doctors/Providers

Department Heads:
Todd Ritzman
Todd Ritzman, MD, FAAOS, FAOA

Chair, Department of Orthopedic Surgery; Director, Spine Center; Pediatric Orthopedic Surgeon

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Physicians/Providers:

Kenneth Bono, MD

Pediatric Orthopedic Surgeon

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Lorena Floccari, MD

Pediatric Orthopedic Surgeon; Research Director, Spine Center

William Schrader, MD

Pediatric Orthopedic Surgeon

Treatments

Scoliosis Treatments

Treatment of scoliosis varies based on your child's age and the severity of the spinal curve. Through Akron Children's Spine Program, we offer the latest innovations in scoliosis treatment tailored to your child's specific needs.

Infants and toddlers

At Akron Children’s, scoliosis in infants and toddlers has been treated with Mehta casts with excellent results. Over a year-long period, your child will be placed in a cast that is changed every 6-12 weeks, depending on their growth. The casts are waterproof, making it easier for you to bathe your child. Once the casting process is complete and your child’s curvature is corrected, a brace will be used to keep the spine in alignment as your child grows.

School-age children

Bracing is frequently used in children ages 5-9. A brace will not typically cure your child’s spine deformity, but it can prevent the curve from increasing.

If your child’s curvature worsens before age 10, the spine may not be large enough to allow a definitive spinal fusion, and we may recommend surgery before your child reaches adolescence. In this case, magnetic growth rods or Shilla implants can be used, depending on your child’s condition. These medical devices encourage continued growth of the spine, while controlling or correcting your child’s spinal curve.

Adolescents and teens

Bracing may be an option for your tween or teen with scoliosis, preventing curve progression 75% of the time. We also offer an innovative form of physical therapy known as the Schroth Method that can optimize your child’s function and may be able to improve bracing’s effectiveness to stop or slow your child’s curve progression and prevent further spinal deformity. The Schroth Method is typically used in children ages 9-17.

If surgery is necessary, our orthopedic surgeons will perform a procedure that corrects the spinal deformity and prevents recurrence of the deformity in adulthood. This is called a spinal fusion and helps prevent long term impacts of a curve’s indefinite progression later in life. The surgeon uses metal rods and screws to correct the spine and keep it straight while it heals.

Akron Children’s spinal surgeons prioritize safety and quality. Complex cases are simplified with the use of the innovative O-Arm Surgical Imaging System. This system uses 3D imaging and navigation in real-time to guide surgeons in performing procedures with a higher degree of precision and safety. By using innovative surgical techniques and routinely performing procedures with two attending surgeons, our orthopedic surgeons are able to perform complex procedures safely and efficiently, reducing blood loss and surgical time, which enables excellent outcomes and expedited recovery. This focus on quality and safety enables your teen to return to the activities they love most.

After a spinal fusion, your teen should be able to ease into activities with some restrictions by 3 months, with a full return to activities by 6 months.

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Mehta casting in infants and toddlers

Although Mehta casting is not a new technique for treating early-onset scoliosis in infants and toddlers, it has been shown to be very effective, particularly in correcting moderate scoliosis. The spine surgeons at Akron Children’s are specially trained in this casting technique, which was developed more than 50 years ago by British orthopedic surgeon, Dr. Min Mehta.

The process

Mehta casting allows for gentle, permanent correction of your child’s infantile scoliosis without surgery. If the curve of your child’s spine is more severe, Mehta casting may also be a good option to improve your child’s curve and delay surgery until your child is older.

Your child will be placed in the Mehta cast for one year. The cast will be changed every 6-12 weeks as your child grows. The first 2 years are a time of rapid growth for children, so the Mehta cast works by helping the spine straighten as it grows. This is also why early detection and treatment of infantile scoliosis are so important. 

To make the process easier and more comfortable for your child, the cast is applied under general anesthesia. Special garments and padding will also be placed under the cast to keep your child as comfortable as possible. Akron Children’s is the only Northeast Ohio hospital that uses waterproof casts, which make it more convenient for you to bathe your child. 

Once the curvature of your child’s spine is corrected, a brace will be used to make sure the spine stays in alignment as your child continues to grow.

Schroth Method

The Schroth Method is an innovative form of physical therapy that can improve your child’s spinal deformity without surgery. At Akron Children’s, it is typically used with children ages 9-17.

The physical therapists of our Spine Program are among just a few in the state who are specially trained in this method. If your child’s spinal deformity can benefit from this treatment, our physical therapists will develop a customized plan for your child. The exercises usually take 30 minutes a day.

The exercises used in the Schroth Method help the curved spine return to a more natural position by focusing on core strengthening. Sometimes used in combination with bracing, the Schroth Method can help improve the brace’s effectiveness in stopping or slowing your child’s curve progression to prevent further spinal deformity. 

The Schroth Method works by strengthening weak muscles in the back to help achieve greater muscular symmetry. It also emphasizes a special breathing technique that helps to rotate the spine and reshape the rib cage and surrounding soft tissue. The Schroth Method will also help your child become more aware of their posture, so they can change positions to reduce the spine’s curvature.

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Back braces for scoliosis

About 20% of children with scoliosis need to wear a back brace, which acts as a holding device to keep the spine from developing more of a curve. A brace won’t make the spine straight, but it may prevent the curve from increasing. There are many different types of back braces, which are typically made of lightweight materials. Some braces are made to be worn 18-20 hours a day, while others are worn only at night.

The type of brace that the orthopedic surgeon chooses depends on the child, the location of the curve, and the severity of the curve. The most common type is a TLSO (thoracic-lumbar-sacral-orthosis) brace. This is a low-profile brace, meaning it comes up under the arms and is worn under the clothes.

TLSO braces include:

  • The Boston Brace. This brace is constructed of custom-fit lightweight plastic and can be worn under clothes, so it isn’t visible. It’s designed to be worn as much as possible, at least 18-20 hours per day.
  • The nighttime bending brace. Also low profile, the nighttime bending brace bends the spine in an effort to straighten the curve as much as possible to prevent it from getting any worse. The brace is designed to only be worn while lying down and sleeping.

Sometimes, even with a brace, surgery becomes necessary to correct the curvature of the spine. Overall, braces prevent surgery about 60-70% of the time. Many studies have clearly shown that braces are most effective when worn the recommended amount of time.

https://www.akronchildrens.org/files/COVID-Inforgraphic.html

What Should Families Expect When They Come for an Appointment?

At Akron Children’s, your child’s health and safety is our priority. Please continue to bring your child for wellness visits, vaccinations or sick care appointments that keep children healthy. We want to assure you that we have taken additional precautions to ensure a safe environment for your child and family. The following are additional safety efforts, in addition to our normal cleaning protocols, that we are taking to help you be comfortable bringing your child to an appointment.

Limiting the Number of Caregivers and Face Covering

The number of caregivers permitted to accompany a child to an appointment is dependent on the department you are visiting. Everyone visiting an Akron Children's facility is asked to wear masks or face coverings, except for kids under 2 or those with sensory issues. Masks will be provided for visitors who do not bring their own.

Health Screening Station Ahead Sign

Checking In and Screening of Visitors

Akron Children's now offers Mobile Check-in to limit your exposure to others. You'll receive a text an hour before your child's appointment arrival time. Click the link in the text when you reach the Akron Children's facility for your child's appointment. You will receive a confirmation text that reminds you to wait in your car. Once we determine appropriate spacing is available inside the building, you'll receive a third text to let you know it's OK to come in for your appointment.

Immediately upon entering the building, your temperature will be taken, either by a thermal scanner or a greeter who will also ask you a few questions.

If you are in a waiting room, you’ll notice signs and a limited number of chairs. This is to remind our patients to keep 6 feet of physical distance between your family and others.

Precautions If You Suspect Your Child Has COVID-19

Call your child’s healthcare professional if your child is sick with fever, cough, or difficulty breathing and has been in close contact with a person known to have COVID-19, or if you live in or have recently traveled from an area with ongoing spread of COVID-19. Your health care professional will work with Ohio’s public health department and the CDC to determine if your child needs to be tested for COVID-19.

View all the safety precautions Akron Children's is taking.


Some of the Conditions We Treat...

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