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Stand-Up MRI Offers Safer, Radiation-Free Option for Scoliosis Patients

Scoliosis is a condition where the spine curves sideways, typically occurring in young people around the time of puberty or during a growth spurt. Children and teens with scoliosis have either an abnormal S-shaped or C-shaped curve of the spine. This abnormal curvature can affect either side of the spine, and occur at different areas along the spinal cord. Scoliosis is actually fairly common – about 3% of adolescents have the condition and there are more than 3 million annual cases in the U.S.

According to the Mayo Clinic, some cases of scoliosis are caused by underlying conditions like cerebral palsy, spina bifida, or muscular dystrophy, but in most instances the cause of scoliosis is unknown. The majority of scoliosis cases are reportedly mild. However, some spine deformities increase in severity as children grow. Severe scoliosis can be a life-altering disability. A profound spinal curve can reduce the amount of space within the patient’s chest, making it difficult for the lungs to expand and function properly.

What are the Symptoms of Scoliosis?

Children and teens with mild scoliosis may not have noticeable symptoms or pain. Some schools routinely test for scoliosis, but it is also recommended that children be screened during regular physician exams.

In some cases a significant change in posture may be a sign of scoliosis. Other signs of scoliosis in children and teens may include:

  • Shoulders are uneven (two different heights)
  • One shoulder blade (in the upper back) sticks out more 
  • One hip looks higher than the other
  • Your child’s rib cage may stick out more on one side when he or she bends forward
  • Your child’s head doesn’t appear centered with the rest of his or her body
  • Clothes not fitting properly
  • A visibly curved spine
  • Leaning to one side
  • When your child stands upward, his or her arms do not hang parallel
  • When your child bends forward, the two sides of his or her back are different heights

Symptoms of scoliosis in adults may include:

  • Shoulders and/or hips are uneven
  • Bump in the lower back
  • Numbness, weakness, or pain in the legs
  • Difficulty walking
  • Difficulty standing up straight
  • Extreme and persistent fatigue
  • Shortness of breath
  • Loss of height
  • Bone spurs (bony bumps in the joints of the spine due to bone and joint damage)
  • Feeling full quickly while eating (due to the spine putting pressure on the stomach)

Females are actually more likely than males to have a scoliosis condition that progressively worsens. According to Boston Children’s Hospital, the three different types of scoliosis include:

  • Idiopathic scoliosis: The most common type of scoliosis, primarily affecting adolescent girls, but also infants, young children, and male adolescents. In younger children, the condition is sometimes referred to as “infantile scoliosis” or “early onset scoliosis.” This type of scoliosis has no known cause.
  • Neuromuscular scoliosis: A side effect of conditions that impair muscles to a point that they are too weak to support the spine, such as cerebral palsy, myopathy, or spina bifida. 
  • Congenital scoliosis: Caused by a failure of the vertebrae to form properly while a baby is developing before birth. It is the least common form of scoliosis and often part of a broad set of developmental issues.

The type and severity of the curve may impact how the disease actually progresses. For example, S-shaped curves are typical in patients with idiopathic scoliosis, whereas C-shaped curves are more common among patients with neuromuscular scoliosis.

What are Some Potential Complications From Scoliosis?

While most people with scoliosis have a mild form of the disorder, scoliosis may cause related complications, including:

  • Lung and heart damage: In severe scoliosis cases, the rib cage may press against the lungs and heart, making it more difficult for the patient to breathe. Additionally, it can be harder for the heart to function properly under these conditions.
  • Back problems: Adults who were diagnosed with scoliosis as children are more likely to suffer from chronic back pain.
  • Appearance: As scoliosis worsens, it can cause more prominent physical changes, such as uneven hips and shoulders, protruding ribs, and a shifting of the waist to one side. Patients with scoliosis frequently report feeling self-conscious about their appearance. Feelings of depression and anxiety are also commonly reported among adolescents impacted by scoliosis. 
  • Post-surgery spinal infection or damage: Though rare, infection and inadvertent error are potential complications from surgery. 
  • Spine or nerve damage from an uncorrected curve: Left untreated, scoliosis can become progressively worse, leading to permanent damage. 
  • Leakage of spinal fluid: A complication seen in the most serious scoliosis cases.

Who is Most at Risk for Developing Scoliosis?

Children who are about to begin the growth spurt that typically occurs just prior to puberty are most at risk for developing scoliosis. Both boys and girls develop scoliosis at about the same rate, but girls have a much higher risk of the curve worsening to a point where treatment is required. Moreover, scoliosis can run in families. Most children, however, who are diagnosed with scoliosis do not have a family history of the disease.

How is Scoliosis Diagnosed?

Doctors will use the following factors to help diagnose and determine treatment options for scoliosis patients:

  • The curve’s position: A curve in the center part of the spine is more likely to increase in severity than a curve in the lower or upper section.
  • The bones’ maturity: The risk of a scoliosis case worsening is lower if the patient’s bones have stopped growing. Braces are more effective while bones are continuing to grow.

Doctors will classify spinal curves as either structural or nonstructural. A structural curve is permanent (often due to a medical condition or injury). A nonstructural curve is temporary, with the spine still structurally normal. For both structural and nonstructural spinal curves, a doctor will attempt to diagnose and then correct or treat the cause.

Doctors use what’s known as the Cobb angle to measure and diagnose scoliosis. The Cobb angle is a measure of the spinal curvature. That measurement is conducted by examining the bones using X-ray or MRI scans together with specialized tools. For scoliosis to be diagnosed, the Cobb angle must be at least 10 degrees. A Cobb angle describes the maximum distance from straight that a scoliotic curve may advance. In many cases, childhood and adolescent scoliosis is mild and does not require treatment. Continued monitoring, however, is strongly recommended.

What are the Treatment Options for Scoliosis Patients?

For patients with a mild case of scoliosis – a Cobb angle curve of 10 to 25 degrees – a doctor will usually have periodic checkups with the patient at three, six, or 12-month intervals to monitor whether or not the condition is advancing. These periodic checkups will typically involve a medical diagnostic imaging test – such as an X-ray or MRI scan – and will continue throughout adolescence to ensure symptoms do not increase.

For a 25 to 40 degree curve, a doctor may recommend that, in addition to periodic checkups, the patient use a scoliosis brace. A scoliosis brace is a medical device worn around the patient’s torso that can help prevent the curve from worsening. 

If the curve is greater than 40 degrees, and the patient’s bones are still developing, a doctor may recommend surgery. Scoliosis surgery is referred to as a spinal fusion. During a spinal fusion procedure, the surgeon will realign and fuse together the curved vertebrae so that they heal into a single, solid bone.

Scoliosis Imaging and Radiation Exposure Precautions:

Scoliosis has traditionally been diagnosed and monitored using X-rays, where we take long scans of the spine and legs to measure the Cobb angle. Doctors must be able to determine the severity of each case and whether the condition can be managed using a brace, or if surgery is required. 

As patients are typically of prepubescent age, we need to be cognizant of the potential impact that radiation can have on the reproductive organs, specifically in females. Reproductive organs represent an area of the body that is most subject to damage from low doses of radiation. And because scoliosis patients can typically require between 10 and 25 X-rays over the course of their treatment, overall exposure to radiation is something that needs to be considered.

Females are born with a finite amount of eggs, and certain precautions are taken when using diagnostics imaging. For example, we typically do not perform X-ray or CT scans on women during the first trimester, as there are a number of potential complications that can occur due to increased radiation exposure. MRI, however, is not a concern given that it is a radiation-free method of diagnostics imaging. 

National Cancer Institute Study Finds Increased Risk of Breast Cancer in Scoliosis Patients:

Between 1912-1965, the National Cancer Institute (NCI) conducted a study on 5,573 female scoliosis patients. Two follow-up studies were also conducted in the 1980s and 1990s. The objective was to evaluate site-specific cancer risks associated with repeated low-dose radiation exposure to diagnostic X-rays (i.e. attempting to determine whether or not a correlation existed between repeated exposure to X-rays and an increased risk of breast cancer). 

The findings were quite alarming to health officials and parents:

  • Eleven breast cancers were reported. 
  • Scoliosis patients had an 80% higher breast cancer risk compared to women in the general population.
  • Based on internal cohort analyses, breast cancer risk increased with both increasing number of X-rays and estimated radiation dose to the breast. 
  • When compared to women in the general population, scoliosis patients had statistically significantly higher risks of dying from breast cancer, and for both incidence and mortality, breast cancer risk increased with increasing diagnostic radiation exposure to the breast. 
  • Patients also had elevated risks for mortality from all causes (circulatory, respiratory, nervous system, musculoskeletal, digestive, and infectious & parasitic diseases) primarily related to degree of spinal curvature.

A UPI article from 1985 entitled, Scoliosis X-rays increase breast cancer risk laid out many of the findings from the NCI’s studies. In the article, Charles Showalter, director of the division of technical development at the Food and Drug Administration’s Center for Devices and Radiological Health, said, “We’re trying to get the message out to people who do scoliosis radiography that they really ought to be careful.” 

Despite the disturbing data regarding an increased risk of various cancers in scoliosis patients, X-rays are still the most commonly used testing protocol today. However, another option exists that is not only safer but often more convenient for patients.

Stand-Up MRI Radiation-Free Technology and Scoliosis:

With Stand-Up MRI machines like we offer at Expert MRI, we’re able to conduct Cobb angle measurements to safely diagnose scoliosis, as well as follow-up scans needed to manage the condition. Stand-Up MRI is a much safer option for prepubescent females because there is no radiation exposure. The advanced technology we use in these machines produces images that allow for a precise diagnosis without repeated exposure to harmful radiation which, over time, can be substantial given the number of scans that are necessary. Radiation-free scoliosis scans can be a significant benefit to the long-term health of the patient, particularly young girls. Moreover, utilizing Stand-Up MRI for scoliosis diagnostics imaging needs can be a more comfortable (and less stressful) patient experience.

Our Stand-Up MRI machines utilize a front open design, which means there is nothing directly obstructing the patient’s field of view while the scan is being conducted. Stand-Up MRI can be an excellent option for children and any patient who may suffer from anxiety or claustrophobia. Patients are able to watch television during their scan, and the entire process only takes about 10 minutes. 

We’re also able to scan the patient in various positions using Stand-Up MRI through the benefit of multi-positional imaging. With Stand-Up MRI’s multi-positional imaging capabilities, spines can be imaged in flexion, extension, and bending (joints can also be rotated into various positions). For an overview of all the advantages available through Stand-Up MRI, take a look at our recent blog.

Why Choose Stand-Up MRI for Scoliosis Imaging?

At Expert MRI, we utilize the latest in state-of-the-art technology to advance injury diagnostics. That means providing patients with cutting-edge testing protocols which ensure the highest standards of accuracy as well as safety. 

Although X-ray remains the most commonly used protocol for diagnosing and monitoring scoliosis patients, Stand-Up MRI is simply a more advanced and safer option for children, particularly young girls. Given everything we know about the risks of radiation, when a radiation-free option like Stand-Up MRI exists (at a comparable price point for overall treatment that is typically covered for most patients by insurance), it’s difficult to make a compelling argument for continuing to use X-ray technology in young scoliosis patients. 

“Stand-Up MRI is just a better option for scoliosis testing because it’s more convenient, accurate, and vastly safer since, unlike X-rays, our patients have zero radiation exposure,” says Expert MRI’s Dr. Sana Khan. 

So, if a safer medical diagnostics alternative exists, why would anyone continue using X-rays on scoliosis patients? At Expert MRI, we view the use of X-rays in scoliosis imaging as a dated, inferior approach. Given everything we know – and have known for several decades – we view Stand-Up MRI as the modern standard for diagnosing and monitoring scoliosis patients.

“I think it’s a matter of time before using X-rays for scoliosis is viewed universally as an archaic method, and eventually discontinued. There’s just no reason to expose young patients to unnecessary radiation when a radiation-free option like Stand-Up MRI exists,” says Expert MRI’s Dr. Andrew Thierry.

Not only is Stand-Up MRI a safer and equally valid diagnostic alternative to radiation-producing X-rays, there are added benefits that patients and parents should consider. Scoliosis patients who undergo MRI scans are not repeatedly exposed to harmful radiation, and if any underlying or asymptomatic conditions are present, MRI technology is able to detect what X-ray technology cannot. Various diseases and abnormalities – including those without any immediate symptoms such as certain types of cancer – can be identified using MRI technology. However, such diseases/abnormalities are not identifiable using X-rays. With an MRI scan, internal organs are examined using a three-dimensional procedure that allows for a more precise diagnosis, but without ever exposing the patient to radiation. MRI is safer, more accurate, and could provide access to invaluable, potentially life-saving information. 

Expert MRI is California’s leading medical diagnostics company because of our commitment to technology, science, and evidence. We believe all patients should have access to the premier standard of medical care, and we strive to provide the very best in medical diagnostics testing protocols and equipment. We also make every effort to ensure your Expert MRI scan is a stress-free and comfortable experience. Our staff of dedicated professionals is committed to your well-being from the moment you walk through our doors. 

If you’re a parent and your child has been diagnosed with scoliosis, we understand that you want nothing but the absolute best for him or her. Reducing unnecessary exposure to radiation is a part of ensuring your child receives the best medical care available. If you have questions regarding radiation-free scoliosis scans utilizing advanced Stand-Up MRI technology, or would like to make an appointment, please contact us online or by phone at 877-MRI-8888.