by Abbey Meyer

When I was officially discharged from my brace, I don’t remember ever having any conversations about how to manage my spine health as I got older. As a teen, I was not thinking about the next decades of my life. Instead, I was thinking about what was directly in front of me - finishing high school and then pursuing college. Little did I know, my journey was far from over. Now, as an adult, post-fusion, post-pregnancy woman living with scoliosis, I would love to share with you what I now know that I wish I knew then.

The conversation of scoliosis naturally revolves around childhood.  The most common type of scoliosis is adolescent idiopathic scoliosis, or scoliosis affecting children in their adolescent years.  One of the driving factors of scoliosis curve progression is growth. When a child is growing, their curve wants to grow with them. Once that child is done growing, the curve should be done curving, right?  But what happens when you finish growing yet still have a large curve? Or what happens when girls with scoliosis grow up to be young women who want to become mothers of their own?  Surely, the changes of adulthood and of the female body during pregnancy have an effect on scoliosis.

When sharing about my scoliosis journey, I’m often asked these same questions.  I certainly do not regret my four years of wearing a back brace or consider my bracing journey as a failure. However, there was curve progression throughout my years of bracing, and my final curve measurement was unlikely to remain stable over time.  To fuse or not to fuse at that age, that is the question.  And I’m sure many of you have either faced that same question personally, or are facing that question for your child.  I am not writing to give you medical advice - that is best provided by your physician who knows your specific curve and circumstances. But, I do think there needs to be a conversation about how to best support, encourage, and inform children with scoliosis as they enter adulthood.

First, your scoliosis journey does not always end when you become skeletally mature. 

I remember celebrating all the milestones that led up to my brace discharge. At that time, I thought that my scoliosis journey ended when I stopped growing and stopped bracing. I never thought beyond my teenage years in terms of my spine health. Turns out, my journey was far from over. My first piece of advice is to find an adult, spine physician and schedule regular x-rays to monitor your curve.  Curves greater than 40 degrees, especially thoracic curves, tend to progress into adulthood at an average rate of 1 degree per year, according to research.  When I finished bracing and reached skeletal maturity at 15, my curve was at 45 degrees.  I had my last pre-pregnancy x-ray when I was 24, and my curve measured 54 degrees.  Almost ten years and three pregnancies later, that curve was pushing 75 degrees.  I only had the x-ray in my twenties because of my connections to a healthcare system.  If I monitored my curve more closely, I think I would’ve been more prepared to handle the news about needing surgery as an adult.

Second, scoliosis and pregnancy does not have to be scary.

The topic of scoliosis and pregnancy is very difficult to decipher in the research. There are not many studies available, and the topic itself is quite complex. Every woman’s pregnancy is different, and things like anesthesia and delivery methods can vary based on personal preferences, doctor preferences, and circumstances. Even without scoliosis, pregnancy often comes with back pain.

Now, add scoliosis into the mix. The good news is that scoliosis does not increase the risk of back pain during pregnancy, according to the research. Curves that are larger prior to pregnancy carry an increased risk of progression. This is not because of the pregnancy itself but simply because of the natural history of scoliosis. As for epidurals, most people with scoliosis can still get them, but be prepared to discuss your scoliosis with your physician.  Meet with the anesthesiologist prior to delivery, if possible, to ensure that he/she is comfortable and knowledgeable about providing anesthesia based on your specific curve pattern.  Even if you do not plan to use anesthesia during delivery, the team needs to be aware of your scoliosis just in case any complications arise.  I personally did not plan for anesthesia and was fortunate to deliver my three babies as desired.  But, I did discuss with an anesthesiologist while I was in early labor with my second baby, and he did not recommend an epidural for me due to the size and location of my curve.  I wish I would have discussed with him earlier because that was the first time that I had even considered it was not a possibility for me.

Remember, the female body can do amazing things. There is no need to worry about your scoliosis increasing your risk for complications, so enjoy this special time!

Lastly, be your own advocate. 

If you have already finished your pediatric scoliosis journey of bracing or surgery, I stand in awe of your accomplishment. I full-heartedly know you will do amazing things as an adult with scoliosis! Don’t forget where you’ve come from or what you’ve been through, especially as you begin to think about pregnancy and motherhood. Your scoliosis is an important part of your story - be proud of it! Keep up with regular check-ins with your spine doctor and stay active. That way, you can keep living your life to the fullest and stay scoliosis strong for years to come.

About Abbey

Abbey works as a pediatric orthotist at Cook Children's. Abbey graduated from UT Southwestern Medical Center at Dallas with her bachelor's degree in prosthetics and orthotics and completed her residencies at Texas Scottish Rite Hospital for Children in Dallas, Texas where she focused on scoliosis and lower extremity orthotics. Abbey gained a passion for her career through her personal experience with scoliosis and wearing an orthosis as an adolescent. In her free time, Abbey enjoys anything outdoors, reading and spending time with her husband and three children.

References

• Singh, M., Yan, Z., Daher, M., Hanna, J., Diebo, B. G., & Daniels, A. H. (2024). Curve progression and clinical outcomes in pregnant females with adolescent idiopathic scoliosis: A systematic review and meta-analysis. World Neurosurgery, 190, e525–e536.

• Theroux, J., Brown, B. T., Marchese, R., Selby, M., Cope, V., McAviney, J., et al. (2023). The impact of pregnancy on women with adolescent idiopathic scoliosis: A scoping review. European Journal of Physical and Rehabilitation Medicine, 59(4), 505–521.

• Grabala, P., Helenius, I., Shah, S. A., Larson, A. N., Buchowski, J. M., Latalski, M., et al. (2020). Impact of pregnancy on loss of deformity correction after pedicle screw instrumentation for adolescent idiopathic scoliosis. World Neurosurgery, 139, e121–e126.

• Dewan, M. C., Mummareddy, N., & Bonfield, C. (2018). The influence of pregnancy on women with adolescent idiopathic scoliosis. European Spine Journal, 27(2), 253–263.

• Danielsson, A. J., & Nachemson, A. L. (2001). Childbearing, curve progression, and sexual function in women 22 years after treatment for adolescent idiopathic scoliosis: A case-control study. Spine, 26(13), 1449–1456.

• Berman, A. T., Cohen, D. L., & Schwentker, E. P. (1982). The effects of pregnancy on idiopathic scoliosis: A preliminary report on eight cases and a review of the literature. Spine, 7(1), 76–77.

• Blount, W. P., & Mellencamp, D. (1980). The effect of pregnancy on idiopathic scoliosis. The Journal of Bone and Joint Surgery. American Volume, 62(7), 1083–1087.