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Scoliosis and spine care

Scoliosis and spine care

Shriners Hospitals for Children — Honolulu offers an extensive and comprehensive program for the care of spinal conditions and deformities. The treatment of a spinal condition, including scoliosis, varies depending on a number of factors. Considerations include the age of the child, remaining growth, and cause and likelihood of progression.

Surgeons at the Honolulu Shriners Hospital use the latest techniques developed in pediatric spinal surgery and practice an evidence-based approach to spine care. Our pediatric orthopaedic spine surgeons consider alternative approaches to spine care and can help patients and parents better understand spine conditions and treatment options.

Spinal deformities and curves include:

  • Adolescent idiopathic scoliosis
  • Congenital scoliosis
  • Early onset scoliosis
  • Kyphosis
  • Neuromuscular scoliosis
  • Scheuermann’s kyphosis
  • Spondylolysis and sondylolisthesis
  • Syndromic scoliosis


Your child will be seen in the clinic by a pediatric orthopaedic surgeon specializing in spinal deformities. A complete history and physical exam will be performed and X-rays may be taken. X-rays done at other centers are reviewed at our hospital as well. Parents should bring any previous documentation and studies (X-rays, CT scans or MRIs) if available.

Once evaluated, a treatment plan will be created, which may include observation, therapy, bracing, casting or surgery.

Second or third opinions on pediatric spinal conditions and deformities are accepted at Shriners Hospitals for Children — Honolulu.


Bracing can be an effective non-surgical treatment for some types of scoliosis. When bracing is applied, the goal is to prevent curve progression and to possibly avoid the need for surgery. Braces are customized to meet the needs of each patient. Our surgeons work closely with our on-site Pediatric Orthotic and Prosthetic Services (POPS) professionals to design and deliver highly effective bracing with a focus on the child’s comfort and social concerns.

Mehta casting

Children with infantile or, early-onset scoliosis are sometimes treated with a series of corrective casts or braces. In select patients it is possible to obtain a complete correction. Mehta casting is often the first line treatment for our younger patients with scoliosis.

Surgery for early-onset scoliosis

When casting and bracing are ineffective, surgery may be recommended to prevent and treat the spinal deformity. In growing children, usually from 5 to 10 years of age, it is important to allow the spinal column to continue to grow in height. Specialized spinal devices are implanted to straighten and control the curvature in children too young to undergo a permanent spinal fusion surgery. The devices are expanded with the child as they grow, usually with a small surgical procedure every six to nine months, which is typically outpatient surgery. Shriners Hospitals for Children — Honolulu uses different growing systems, including VEPTR (vertical expandable prosthetic titanium ribs), growing rods and the MAGEC system. The MAGEC system is a tremendous advance in pediatric spine care. After implantation the rods can be lengthened in the clinic using a magnetic device. Recommendation as to which device is best for your child depends on a number of factors. Each treatment plan is individualized with a full explanation as to the goals of treatment.

Spinal fusion

Spinal fusion is a surgical procedure that involves implanting corrective rods, which straighten the spine and fuse some of the vertebrae in the spine, to obtain permanent correction. In most cases, movement of the spine following spinal fusion is the same as before the surgery. Most patients are able to return to most of their everyday activities, including sports.

The medical team

Craig M. Ono, M.D.
Paul Moroz, M.D.
Jonathan Pellett, M.D.
Kyle Mitsunaga, M.D.
Lance Mitsunaga, M.D.

Less radiation

The Honolulu Shriners Hospital is the first hospital in Hawaii to have the EOS imaging system. EOS is a whole body imaging system with an ultra-low dose of radiology. The scan takes only 20 seconds. According to recent studies, EOS imaging has up to 85 percent less radiation compared to conventional X-rays. This is important because children with scoliosis and other orthopaedic spine conditions are required to have many X-rays over their lifetime to monitor their condition. The EOS imaging system is based on Nobel Prize-winning technology. 

Collaborative approach to care

Our pediatric orthopaedic spine team works with primary care physicians, allied health professionals, such as physical therapists, bracing specialists and others, along with parents and the patient, to develop a comprehensive, family-centered treatment plan that meets the individual needs of each child. Through innovative pediatric care, we instill confidence and teach children that there are no limits to what they can do. Regardless of your child’s medical condition or needs, you can expect to benefit from the expertise of the team dedicated to the needs of your child. Our hospital helps ensure patients receive an optimal outcome by providing all aspects of inpatient and outpatient pediatric orthopaedic care, including surgery, on-site rehabilitation, treatment, support and education.