Orthopedics Archives - Nemours Blog


Quinn’s Scoliosis Journey

“We are so happy with Dr. Khoury and what he’s been able to do for our son. He is an amazing doctor. He always treats everyone with respect. We are excited to continue our scoliosis journey with Dr. Khoury and Nemours.” –Mom to Quinn (age 4) Quinn’s mom first noticed something was wrong with his back when he was just 2 months old. “I could feel a bump on one side of his back,” she explains. “I thought it was lack of muscle tone…I didn’t know that what I was feeling was the rib hump.” When she mentioned this to Quinn’s pediatrician, she diagnosed him with torticollis and Quinn began doing physical therapy. His torticollis eventually got better, but mom knew there was still something wrong with his back. That was because Quinn didn’t sit on his own until around 8 months, and he didn’t crawl until after 9 months. […]

Apifix: A Unique New Scoliosis Treatment Option

Contributed by Kevin Neal, MD, orthopedic surgeon What is the Apifix device that is used to treat scoliosis? The Apifix device has a few different names. It can also be called minimally invasive deformity correction (MID-C) or an “internal brace.” The Apifix device is a rod that is used to straighten scoliosis curves without a major spine fusion. Why do some patients want to avoid spine fusion? A spine fusion is where the vertebral bodies are stabilized so they can’t move, typically with rods and screws. The joints between the vertebrae bones are removed and bone graft is placed to help the vertebral bodies grow together and become solid. Preventing movement of the spine keeps scoliosis curves from getting worse and keeps the spine straight after it has been corrected. Spine fusion is a great operation for many patients with scoliosis. But some patients want to treat their scoliosis without […]

Dancing Perfection- Samantha’s Spine Story

During a routine scoliosis check in school, Samantha received some alarming news. She was diagnosed with scoliosis and her spine had grown into an S shape. After meeting with multiple doctors and specialists, Samantha’s family decided to come to Nemours Children’s Hospital, Delaware to meet with Dr. Suken Shah, pediatric orthopedic surgeon. Due to the severity of the curve, Dr. Shah determined that a posterior spinal fusion was needed to correct her spine and prevent pain and disability in later life. Samantha was nervous but determined. She continued dancing, her passion, up until the day of her surgery. Her determination continued as she was able to stand within hours of her surgery, and walked the hospital halls the next day thanks to excellent pain management and the Nemours rapid recovery pathway.  She was also thrilled to learn she had grown a couple of Inches! Not sure she would ever dance again, Samantha […]

An International Search of Hope- Maria’s Story

Contributed by Maria’s dad Shahid. When Maria was 10 months old, we noticed some abnormalities in her chest and back, but we weren’t able to find a hospital or doctor who understood her situation.  She was frequently ill with pneumonia and breathing was painful. Her condition eventually worsened.   When she was 18 months old, we met a doctor in Peshawar, Pakistan who diagnosed Maria with MPS. It was our first time hearing the word MPS (Mucopolysaccharidosis), so we did online research and reached out to other families. Unfortunately, there is no treatment for rare diseases in Pakistan and there was no family to guide us for diagnosis and treatment. I sent Maria’s bio-samples to India, and Germany where they confirmed that she had MPS, but they were unable to determine her type of MPS. So, I sent her samples to the US and a diagnosis with MPS IV was […]

Achieving Milestones with a Disability- Emily’s Cerebral Palsy Journey

Contributed by Emily’s mom Elizabeth. Emily is an AMAZING little girl! At 5-years-old, she is comfortable telling people she has a disability and that her muscles work differently than theirs do. Emily was born three months early and diagnosed with cerebral palsy when she was about a year and a half old. Both Emily and her identical twin sister, Sarah, were delayed in reaching their milestones, but Emily’s delays were more pronounced.  Emily is super determined and does everything she can to keep up with her peers. This requires A LOT of hard work! Emily does about 6-7 hours of therapy a week, a combination of PT, OT, and aqua therapy. Since she was about 3, Emily has received intermittent Botox injections to loosen her muscles and give her some additional flexibility and mobility. For example, she learned to walk with lofstrand crutches within 6 months, a task they rarely teach children her age given […]

Expert Question and Answer

Live Q&A: Spine & Scoliosis

In this video, recorded on June 28, 2021, Suken Shah, MD Chief, Spine & Scoliosis Center and Brett Shannon, MD, orthopedic surgeon, discuss and answer questions about scoliosis. Learn more about: When and why your child may need surgery. What surgery is like. Life with spinal fusion surgery. Complications and risks. If you have questions for Dr. Shah and Dr. Shannon, post them in the comments section on Facebook. Q: When a pediatrician first discovers a small curve in a young child, what is the best way to approach the new diagnosis? A: Kids under age 10 are more likely than older kids to need further monitoring, or even sometimes intervention from an orthopedic surgery team. If you detect any asymmetry of the back, or trunk, or shoulders, it’s important to have them come in and see us for a further evaluation. This includes the child’s history and a physical […]

Expert Question and Answer

Expert Q&A: Osteogenesis Imperfecta (OI)

Questions about osteogenesis imperfecta (OI), or “brittle bone disease,” are answered by pediatric orthopedics experts at Nemours Children’s Health. Q: When should people with OI get rods in the bones in the legs? A: We view realigning and rodding the bones in the legs, femurs and the tibias as a way to address deformity or bowing that is interfering with each patient’s motor development or causing recurrent fractures. We feel there is no minimum age, this is something that we really do value, continually assessing on an individualized basis to help each patient reach their potential. Q: How would you describe the use of orthotics in patients with OI? A: The word orthotics generally refers to all types of braces or things we put on patients’ arms or legs to help them function better. We use them on a case-by-case basis. Years ago we used to use heavy long leg […]

Expert Question and Answer

Expert Q&A: Cerebral Palsy

During this Q&A session, Kathleen Miller-Skomorucha, occupational therapist, and Carrie Sewell Roberts, social worker, answer questions about maximizing the potential of your child with cerebral palsy (CP) by working with your care team to set goals. Carrie is a social worker and mom to a 13-year-old daughter with CP. Throughout this discussion, she shares with us different examples of what has worked for her family, but also a plethora of resources families can use for their own means. When you’re thinking about setting goals for your child’s future, an important first step is to set a framework. For example, there’s a structure called “Person-Centered Future Planning.” She talks about ways families can use resources like the ones below to work with their child and care team to create shared goals. Kathleen is an occupational therapist who treats patients with CP. She shares her unique perspective as a therapist, discussing goals for therapy. It’s important […]

Curve Alert

Curve Alert: Don’t Miss That Scoliosis Screening

Because of the COVID pandemic, you may be putting off visits to your child’s pediatrician. But a missed well visit could mean missing a scoliosis screening. What is scoliosis? Scoliosis is an S-shaped curve in the spine.  It is a condition that occurs equally in boys and girls; however, the curve tends to increase more often in girls. Small curves usually don’t cause problems. But large curves can cause health problems like pain or trouble breathing. What causes scoliosis? The most common form of scoliosis is idiopathic which means “cause unknown.” Kids of any age — even infants — can have idiopathic scoliosis. But it’s usually found when a child begins going through puberty. How do you know your child might have scoliosis? Most often, parents, pediatricians or school nurses may notice one or more of the following signs of scoliosis: One shoulder blade more prominent Ribcage is shifted to one […]

Anthony’s Scoliosis Journey

This post was written by Anthony’s mom, Debbie.  “Something was Different” Anthony was about six months old when I started to notice something was different about his back. He would roll over and try to sit up and there was an obvious bulge/curvature in his spine. I took him to my pediatrician who told me there wasn’t anything to worry about. He informed me that some children take a bit longer to sit up on their own. At this time, I had two-year-old twins at home and was very aware that children progress differently, but there was no overlooking the curve of his spine. Unhappy with that visit, I scheduled an appointment with a specialist at a hospital in Philadelphia, PA. Finally a Diagnosis Anthony was about a year old when he was diagnosed with infantile scoliosis. My family was with me in the room when the doctor put his […]

For Kids with Scoliosis: Nemours Host 4th Annual Mentoring Event, powered by Nemours Children's Health System

For Kids with Scoliosis, Nemours Hosts 4th Annual Mentoring Event

This year marked the fourth time that patients and families gathered to share stories, common concerns, and inspiration at our annual Patient and Parent Mentoring Event, hosted by the Nemours Spine and Scoliosis Center. More than 100 people gathered at Nemours/Alfred I. duPont Hospital for Children on a gorgeous spring day. As in years past, this event was open to families with adolescents who have idiopathic scoliosis, which is the most common form of the disease. More than 3% of the population has scoliosis, a condition that causes the spine to curve from side to side. For some, no treatment is necessary, just periodic monitoring of the curve by a healthcare provider. For others, treatment is required, which can include bracing to halt or slow down the progression of the curve, or surgery to correct the deformity. At the mentoring event this year, Dr. Suken Shah started things off by […]

Osgood-Schlatter Disease, Powered by Nemours Children's Health System

Kids’ Knee Pain: Is It Osgood-Schlatter Disease?

I remember when my son was 12 years old, he would wake up in the middle of the night crying and complaining of knee pain. He had started to run track in middle school, and he started to get a little bump just below his knee cap at the top of his shin bone. Our pediatrician called it “growing pains” and said it would go away. He recommended that he do some stretches and ice after track practice. Eventually it did resolve once track season was over, and he didn’t have any problems after that. What I found out later is that this wasn’t growing pains at all – it was a common sports injury known as “Osgood-Schlatter disease.” What is Osgood-Schlatter disease? Although it sounds scary because of the word “disease,” Osgood-Schlatter is one of the most common causes of knee pain in adolescents. It’s an overuse injury that […]

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