For most teenagers, a scoliosis diagnosis means wearing a brace to prevent further curvature of the spine. But in rare cases, spine surgery is the best option. That was the case for Zachary Darr, 16, a track athlete and aspiring Eagle Scout.
Scoliosis is a condition that causes a curvature of the spine. It affects about 2% to 3% of people in the United States.
"Zachary always wanted to have his back scratched while we worship on Sundays," says his mother, Ashley Darr. "Over time, I noticed a hump on his right shoulder blade. I asked his pediatrician at the next visit what it was. He immediately ordered X-rays for suspicion of scoliosis. The X-rays confirmed the suspicion."
Zachary’s scoliosis diagnosis
Zachary was diagnosed with adolescent idiopathic scoliosis of the thoracic region in March 2019. "Adolescent" means the condition affects children and teens between the ages of 10 and when they finish growing. "Idiopathic" means there is no other condition causing the spinal curvature. While it is more common in females, it can occur in male patients as well.
Scoliosis typically causes no issues or pain unless there is a very large curve. Most often, it’s discovered during what’s called a "forward-bend" test at pediatrician checkups, where the patient leans forward and one side of their back looks higher than the other side.
"Scoliosis can range from a small, almost unnoticeable curve to a large curve that can have a significant impact on a person’s health and quality of life," says Dr. Michael Hughes, a pediatric orthopaedic surgeon at Atrium Health Wake Forest Baptist Brenner Children’s Hospital and assistant professor of orthopaedic surgery at Wake Forest University School of Medicine.
"If their curve is small, we typically monitor patients with X-rays every several months to make sure the curve isn’t getting bigger," says Dr. Hughes. "If the curve becomes moderate, and the patient is still growing, using a brace can help prevent the curve from getting too big."
While braces aren’t designed to permanently correct scoliosis, they hold the spine in a partially correct position to prevent the spinal curve from growing. Once the patient is done growing, they can stop using the brace and shouldn’t have any issues with the curve in the future.
"These are not the braces your mother or aunt had," says Hughes. "We now use high-tech, custom-fit slim braces that can even be worn under regular clothing and are almost unnoticeable. Also, we have certain braces that are designed to only be worn at night while you sleep."
The last resort in scoliosis treatment is surgery, which is what Zachary needed.
"For Zachary, by the time his curve was noticed, it was already in the 'too big' range," says Hughes. "Bracing only works to keep small to medium curves from becoming big curves - it doesn’t work for big curves."
Meeting with Dr. Hughes
Zachary was referred to Dr. Hughes because of Dr. Hughes’ and Brenner Children’s Hospital’s expertise in treating pediatric spine conditions. Brenner Children’s Hospital is the only children’s hospital in the region with orthopedic physicians who specialize in treating children.
"In Zachary’s words, 'Dr. Hughes was cool,'" says Ashley. "As parents who have met and been patients of several surgeons, we immediately liked Dr. Hughes. He was down to earth, very approachable and easy to talk with. He found ways to connect with Zachary and that meant a lot. He gave the facts and in no way pushed us in either direction. He armed us with great information and sources to review, and an awesome resource on his staff for questions."
Ultimately, Zachary and his family decided to pursue the surgery.
Zachary’s scoliosis surgery
In July 2022, Zachary underwent a posterior instrumented spinal fusion. The goal of Zachary’s surgery was to prevent his back curve from getting bigger. An added benefit of the procedure was partially straightening the existing curve.
"The surgery was a success," says Ashley. "We were kept informed with communication from Dr. Hughes’ staff. As parents, we worried, of course, but knew God had placed us in the right place with the right care."
Zachary’s scoliosis surgery recovery
Zachary’s recovery process went smoothly and he healed quickly.
"Typically, patients spend two to three days at the hospital, anywhere from three to four weeks out of school, and by three months, are usually allowed to start light exercises like jogging again," says Hughes. "Many patients are allowed back to competitive sports by six months."
Scoliosis surgery has made amazing strides in the last 20 to 30 years.
"What used to be a huge, all-day surgery with a week-long hospital stay is now a procedure that is wrapping up around lunchtime, the patient is up and walking around the next day, and usually goes home after only two to three days," says Hughes. "We also are constantly improving all aspects of care, including things like new multi-modal pain management for surgical patients that have dramatically decreased narcotic use and decreased patients’ post-operative pain."
The importance of scoliosis treatment
While spine surgery is rare in teenagers, it can be necessary to prevent future issues.
"Scoliosis typically only causes issues when the curve gets very large," says Hughes. "Even though it might not be that large until a patient is 45 or 50 years old, surgical correction at that point is more difficult and dangerous, and patients may even have developed other medical problems at that point that make surgery riskier. By being proactive (in treating younger patients), we know we can prevent major problems in the future. This can make a huge difference in the lives of these patients."
Zachary’s full recovery from scoliosis surgery
"Zachary never had restrictions prior to surgery and never let scoliosis slow him down," says Ashley. "But now, as parents, we see his self-esteem is much greater. He is working out more and seems to be happier and less self-conscious."
Zachary is a track athlete and competes in the 100-meter and 200-meter races as well as shot put and discus events. He is also a Life Scout and is working toward his Eagle Scout requirements.
Zachary and his family are grateful for the care they received with Hughes and Brenner Children’s Hospital.
"Dr. Hughes has a wonderful team in the clinic and in the hospital," says Ashley. "He really talked with Zachary as a person, asked him questions and explained everything in as much detail as we wanted. He didn't ignore Zachary because he is a child. He valued Zachary as a person and as the patient."
Hughes adds, "It has been a true pleasure getting to work with Zachary and his family. I love my job because I get to build partnerships with patients and their families on some pretty big journeys. My team and I are always honored and humbled to play whatever role we can in caring for children and their families. I want to thank Zachary and his family for their trust and teamwork."
If your child has scoliosis, it’s essential to seek the right type of care with professionals who specialize in treating the condition. Learn more about pediatric scoliosis treatment at Brenner Children’s Hospital.