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Innovative Scoliosis Monitoring: Joey’s Story
An active young girl keeps her scoliosis under control with the help of advanced imaging technology.
Joey's Story: Highlights
- Joey’s pediatrician caught her scoliosis early, so she does not need surgery.
- Johns Hopkins uses a new kind of imaging system to monitor the progress of her treatment.
- With regular screening and consistent bracing and exercise, Joey’s curvature should continue to improve.
An active middle school student and goalie of her soccer team, Josephine, who goes by “Joey,” never had any back problems. During Joey’s annual checkup, her pediatrician performed a routine scoliosis screening. The doctor suspected adolescent idiopathic scoliosis — a sideways curvature of the spine that starts during the early adolescent years without a clear cause. She recommended that Joey get an X-ray, which confirmed the diagnosis. Joey was referred to the Johns Hopkins Department of Pediatric Orthopaedic Surgery for treatment.
Joey’s mom, Jo, explains that the Johns Hopkins team was impressed at how promptly Joey’s pediatrician, Jacqueline Brown, M.D., noticed the signs of scoliosis. Grateful to the pediatrician, Jo says, “I even sent a gift basket to thank her.”
Joey was 11 at the time of her diagnosis, and was still growing. “Growth can make scoliosis worse,” explains Joey’s orthopaedic nurse practitioner Kristen Venuti, C.R.N.P. “Joey is growing fast and requires follow-up visits with me every four months for scoliosis monitoring and treatment.”
Venuti recommended a few options to help control Joey’s spine, including bracing and physical therapy. Jo decided on a combination of both to take the most aggressive approach and help her daughter avoid worsening scoliosis.
A New Kind of X-Ray
Joey’s treatment also involves regular X-rays of her spine. Three times a year, Jo brings her daughter to the Johns Hopkins Outpatient Center to meet with Venuti and undergo routine scans to monitor her spine’s curvature.
“The best way to spot worsening scoliosis is with a standing full spine X-ray,” explains Venuti.
However, frequent X-rays can mean a significant amount of radiation accumulates in the patient’s body. While the occasional X-ray for a broken bone isn’t much to worry about, radiation levels can be a concern for people with chronic conditions that require regular imaging, like scoliosis.
The Women’s Board of The Johns Hopkins Hospital saw a need for imaging options, such as the EOS imaging system, that offer lower levels of radiation. The board donated this new, cutting-edge imaging machine to the Johns Hopkins Outpatient Center with patients like Joey in mind.
Lower Levels of Radiation: Safer for Patients
The new imaging system creates clearer images of patients in a natural, standing position, which helps orthopaedists see spine, hip and leg disorders. Patients benefit, too: The more advanced scanner also produces much less radiation than traditional scanners. Venuti says that less radiation “is critical to offering our patients the most up-to-date, advanced assessment and treatment.”
The machine takes two images at the same time: one from the front and another from the side. The whole process takes less than one minute. Jo says, “As a parent, knowing my daughter is getting less radiation exposure while she’s still growing is a great feeling.”
Slow and Steady Progress
Joey’s treatment started with wearing a scoliosis brace for 10 hours each night. She also went to physical therapy twice a week for six months, learning exercises through the Schroth method to strengthen her core. She now does these exercises at home.
“She’s such an honest kid,” says Jo. “She’ll tell on herself if she knows she hasn’t exercised enough.”
Thanks to early detection and treatment, Joey’s spine curvature has not become severe. When Joey’s scans showed promising results, Venuti told her that she can go brace-free one night a week. As Joey realized that her workouts could mean less time in the brace, she used it as an incentive and doubled down on her exercise regimen.
Thanks to these interventions alongside regular low-radiation imaging, Joey’s scoliosis should remain mild. She can keep playing soccer and participating in other favorite activities such as horseback riding, swimming and running.
Scoliosis is often first diagnosed in children, but treatment and monitoring may be lifelong. Common signs of scoliosis include a difference in shoulder height when viewed from the back, a head that is not centered with the rest of the body, or a difference in hip height or position.
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