Screening, Treating, and Living Life… with Scoliosis – PediaCast 596
Podcast: Download
Subscribe: RSS
Show Notes
Description
Dr Allen Kadado and Crystal Seilhamer visit the studio as we consider scoliosis. This common condition sounds scary, but those affected are not alone. We break down scoliosis and provide straight facts for families. We hope you can join us!
Topic
Scoliosis
Guests
Dr Allen Kadado
Pediatric Orthopedic Surgeon
Nationwide Children’s Hospital
Crystal Seilhamer
Nurse Practitioner and Program Coordinator
Center for Comprehensive Spine Care
Links
Center for Comprehensive Spine Care at Nationwide Children’s Hospital
What is Scoliosis? (Scoliosis Research Society)
What is Scoliosis? (Setting Scoliosis Straight)
OrthoKids: What is Scoliosis? (Pediatric Orthopedic Society of North America)
What is Early Onset Scoliosis? (Pediatric Spine Foundation)
Higgy Bears: Making Scoliosis Bearable
Episode Transcript
[Dr Mike Patrick]
This episode of PediaCast is brought to you by the Center for Comprehensive Spine Care at Nationwide Children's Hospital.
[Music]
[Dr Mike Patrick]
Hello, everyone, and welcome to another episode of PediaCast. We are a pediatric podcast for moms and dads.
This is Dr. Mike coming to you from the campus of Nationwide Children's Hospital. We're in Columbus, Ohio. It's episode 596.
We're calling this one Screening Treatment and Living Life with Scoliosis. I want to welcome all of you to the program. We are so happy to have you with us again.
Scoliosis can sound scary for kids and families, especially when it's first mentioned during a school screening or a visit to your child's pediatrician. However, if your family is impacted by scoliosis, you are not alone. It's a common condition in kids, and today we will break it down.
We're going to explore the cause, signs, and symptoms of scoliosis, how it is diagnosed and treated, and what it means for your child's everyday life. We'll also consider things parents can do to support their family's scoliosis journey. Of course, in our usual PediaCast fashion, we have a couple of terrific guests joining us in the studio to discuss the topic.
Dr. Allen Kadado is a pediatric orthopedic surgeon at Nationwide Children's Hospital, and Crystal Seilhamer is a nurse practitioner and program coordinator for the Center for Comprehensive Spine Care at Nationwide Children's Hospital. Before we get to them, I do want to remind you the information presented in every episode of our podcast is for general educational purposes only. We do not diagnose medical conditions or formulate treatment plans for specific individuals.
If you are concerned about your child's health, be sure to call your health care provider. Also, your use of this audio program is subject to the PediaCast Terms of Use Agreement, which you can find at pediacast.org. So, let's take a quick break.
We'll get our guests settled into the studio, and then we will be back to talk about scoliosis. It's coming up right after this.
[Music]
[Dr Mike Patrick]
Dr. Allen Kadado is a pediatric orthopedic surgeon at Nationwide Children's Hospital and an assistant professor of pediatrics at the Ohio State University College of Medicine. Crystal Seilhamer is a nurse practitioner and program coordinator for the Center for Comprehensive Spine Care at Nationwide Children's. Both have a passion for supporting children, teenagers, and families impacted by scoliosis. That's what they're here to talk about, screening, treatment, and living life with scoliosis.
Before we dive in, let's offer a warm PediaCast welcome to our guests, Dr. Allen Kadado and Crystal Seilhamer. Thank you both for stopping by today.
[Dr Allen Kadado]
Thank you, Dr. Mike, for having us on the podcast. We're very excited.
[Crystal Seilhamer]
Yes, thank you so much for having us here.
[Dr Mike Patrick]
Yeah, I'm really excited to talk about this as well because it's something that we deal with and a lot of providers screen for and see, and so just getting a nice update on this is going to be helpful, I think, for everybody. So, let's start with the basics. Allen, what is scoliosis and how is it different from other spine conditions?
I remember back from medical school, we learned about lordosis and kyphosis, and scoliosis was kind of part of the trio. What are those things and the difference between them?
[Dr Allen Kadado]
Yeah, perfect. That's a great place to start. So, by definition, scoliosis is a lateral curvature or a sideways curvature of the spine.
So, if you're looking at the child from front to back or back to front, the spine curves sideways, and that's scoliosis. We know that scoliosis is a three-dimensional deformity, so there's the sideways curvature. There's also some sagittal curvature.
So, if you're looking at the child from the side, that's called kyphosis and lordosis. Okay, so different plane at what you're looking at the child. But all of these are three-dimensional deformities.
There are some rotational components of the spine as well, and we can get into that a little bit later. But scoliosis in itself is a lateral curvature or sideways curve of the spine.
[Dr Mike Patrick]
And then, Crystal, when and where are kids typically screened for scoliosis? Because this doesn't just happen, hopefully, in the doctor's office. Hopefully, there's some other places that this is kind of being watched as well.
[Crystal Seilhamer]
Yeah, so screening for scoliosis has been a bit controversial. The U.S. Preventive Services Task Force had made some recommendations a while back saying that kids should not be screened in schools and things anymore. However, the orthopedic societies are trying to get those recommendations from our standpoint back out there that kids really do benefit from being screened so that early detection can happen.
So, schools are starting to screen. So, a school nurse, sometimes in gym class, a child may be screened. And that's generally during that like middle school, getting ready to hit puberty stage for girls and boys.
A little bit different time frame as girls typically mature a bit earlier and can have a higher progression rate if they do have a curvature. So, we do like to catch the girls a little bit earlier if possible. But we also encourage families to look at their child's back if possible.
And hopefully the pediatricians are looking at those during their well-child checks as well.
[Dr Mike Patrick]
Yeah. Yeah. Very important because often there's no symptoms, especially with early scoliosis.
And so that screening is really one of the only ways that you're going to see it. You mentioned that, you know, right before puberty and sort of during puberty, the early teenage years, that's when the spine is growing the fastest. And so, the curve is going to be more, I don't know, as it grows, you see the curve happen maybe a little bit faster.
Allen, is that an accurate depiction?
[Dr Allen Kadado]
That is absolutely accurate. So, scoliosis worsening or scoliosis progression, worsening of the curve, it occurs in phases of rapid growth. So, you may think of that as a growth spurt.
You're growing most rapidly as a little baby, you know, by age zero to 12 months. And then you hit the second peak and at this time called puberty. And around puberty during that adolescent growth spurt, that's when we notice scoliosis progression at its highest risk.
And that's typically when we would recommend scoliosis screening. So, scoliosis may show and may progress during that sensitive time phase.
[Dr Mike Patrick]
And then Crystal, what does the screening actually look like? How are kids screened?
[Crystal Seilhamer]
So typically looking at a child's back when they're standing and then when they're also bending forward, we're looking at if shoulders are even. Sometimes one shoulder can be a lot higher than the other. We hear parents say, we thought they just had poor posture.
Sometimes when the child's bending forward, you can see part of the ribs sticking up on one side or the scapulas, the shoulder blades will look uneven. And also, girls will complain about their waist looking uneven in a swimsuit or in a dress. And so those are some things that the health care provider, school nurse, or obviously even parents are noticing during that screening, that screening process.
[Dr Mike Patrick]
And then Allen, what causes scoliosis? There are lots of myths out there, you know, like a heavy book bag on one shoulder and using it on that same shoulder. Does that cause it?
[Dr Allen Kadado]
You know, that's a very humbling question. The most common type of scoliosis is something called adolescent idiopathic scoliosis. Now the word idiopathic is a big word for we just don't know.
There's been a lot of research going into this space looking at genetics, looking at molecular biology, looking at the skeletal muscles and the bones. There's a lot that we know about characteristics of scoliosis, but the cause of adolescent idiopathic scoliosis is less well accepted or less well known. So really to date, for the most common type, we don't know.
For other types of scoliosis, there are some known causes, and some may be related to genetic syndromes or neuromuscular disorders or congenital abnormalities of the actual vertebra, so structural abnormalities. But again, the vast majority in this population is idiopathic, meaning we don't know.
[Dr Mike Patrick]
Yeah. Do we think that there's a genetic component to it?
[Dr Allen Kadado]
There have been genes described in idiopathic scoliosis. There is a genetic component. It is less homogenous though, so there's not like one gene that you get that causes scoliosis.
What we do know, however, is that if mother, for example, has scoliosis, the child may be more likely to also develop a scoliosis as compared to a family member without.
[Dr Mike Patrick]
Yeah, yeah. For the most part, and maybe a hundred percent, it's not anyone's fault, right? Like, you know, if you do wear a heavy book bag on one shoulder, I mean, maybe you should distribute the weight evenly, but that's also so you don't pull a muscle.
But it's not anyone's fault. It just happens, right?
[Dr Allen Kadado]
That is absolutely correct. It's not like a heavy book bag on one shoulder causes the actual structural spinal deformity. You may have your child wear your backpack, you know, on one shoulder and it drags it down.
That's more of a temporary postural imbalance. We don't think backpacks cause the spinal deformity. Can it cause some asymmetries?
Sure, but from a real genuine spinal deformity, it's very unlikely. And it's also, you know, other common questions are mattresses. There isn't a specific mattress that causes scoliosis.
Typically, not a specific way that the child is sitting or standing that's going to cause a big severe spinal deformity. Those are more so the asymmetries.
[Dr Mike Patrick]
Okay, and so when parents say, hey, you know, straighten your back or have a better posture, doing that's not going to cause scoliosis. There may be other reasons that you, you know, want your child to have good posture, but it's not to prevent scoliosis.
[Dr Allen Kadado]
Yeah, teenagers love hearing their mother say, stand up straight. So, we always advocate for that. But no, it's not like that's going to cause scoliosis.
More often what we see with the kind of the stand-up straight phenomenon is kyphosis. So that's that natural hunch to your thoracic spine to your back. And some kids just have a bit more of a hunch.
[Dr Mike Patrick]
Now, let's say during the screening that we do discover some asymmetry, that we're concerned that there could be scoliosis. What happens next? How do we continue the evaluation if we have a concern during the screening?
Helen?
[Dr Allen Kadado]
Yeah, so typically if some asymmetry is noted on a physical exam, so looking at the child, that will often generate a referral to us or a radiograph with the pediatrician. So, radiograph x-ray is the next appropriate step. So, getting a full-length x-ray of the child's spine from top to bottom, and we're able to assess the characteristics of that child's spine.
We can measure the curvature, and we usually get two plans. So, from the front or the back and also from the side.
[Dr Mike Patrick]
And then the angle that you're measuring, I'm just going to mention it's called a Cobb angle. And I mentioned that for the folks out in the audience. You may see that in the in the medical report.
I would imagine that's just named after some guy who first figured out how to make the measurement.
[Dr Allen Kadado]
Yes, Dr. John Cobb. So, the Cobb angle is our way of measuring the magnitude or the severity of scoliosis. So, we take the most tilted vertebra to the next most tilted vertebra, and we draw a line parallel to the end plates of those vertebrae.
And that generates an angle, and that's what we call the Cobb angle. So that helps us decide on the severity or the magnitude. It also helps determine management.
The Cobb angle is a little imperfect, and I think it's important for parents to know that. It's really the Cobb angle is a surrogate for spinal deformity. So, it's only a 2D or two-dimensional assessment of the curve, and we know that it's a three-dimensional deformity.
[Dr Mike Patrick]
And so, when you say that there's a rotational component, folks, of scoliosis, that just makes it a little bit more complicated in what the spine looks like since it's the angle is not in necessarily a perfect plane.
[Dr Allen Kadado]
That's correct. The spine twists as it's turning to the side, and that twist actually generates what we usually see on physical exam with the shoulder asymmetry and the rib hump and things like that.
[Dr Mike Patrick]
Now that angle, depending on what it is, sort of can dictate how it's treated, but it also helps us to follow it along. So, sort of to watch and see, is this curve getting worse? Is it pretty stable?
Yeah, I imagine that a lot of families, Crystal, get frustrated with just watching weight. Like, especially in today's age, you know, we want everything now. We don't really have a lot of patients, you know.
Everything is instantly available on the internet, and watching and waiting for just about anything can be sort of frustrating. Do you find that true in this case as well?
[Crystal Seilhamer]
Yes, that is a very good point, and some families do get frustrated with that. I think we try to continually educate them. Like, we are assessing the back.
We are looking at the x-rays. Typically, if the curve is below a 20- or 25-degree mark, we are okay with watching it, and we typically tell families the research that we have, the data that we have, shows that a curve that's small or mild in that regard is not going to progress super-fast. We also reassure families that if they do have a curve in that range, we do want to see them back, and we want to see them back often.
Some families want to get x-rays sooner than a four-month or six-month visit, but we try to balance that with how much x-rays, radiation that they're getting versus how we feel like the curve is going to progress based on how old they are and just how much growth that they may have left.
[Dr Mike Patrick]
Yeah, what are some of the options in terms of time in between x-rays or evaluations?
[Crystal Seilhamer]
Yeah, typically, again, it depends on where they're at in their puberty phase. Sometimes we'll have them come back in a three to four-month period if we feel like we're seeing any changes at all, but sometimes we're comfortable with six months if the curve has been pretty stable, but we still want to keep eyes on them. We'll have them come back at that six-month range, and sometimes families will call in, and we will encourage them to do that, like, hey, I feel like I'm seeing an extra humpback here.
Something doesn't look right, and if that's the case, we are always happy to see them back sooner than scheduled.
[Dr Mike Patrick]
What can families do between those observation visits to support their child?
[Crystal Seilhamer]
We always encourage them to stay active, stay in their sport, you know, go outside, ride your bike, get off your cell phone. But yeah, a lot of families have, some families I've talked to have even, like, pulled their child out of their sport because they had scoliosis, so we do try to give that education that, you know, have your child stay as flexible as possible, have their core stay strong. All of that is only going to help, not hurt at all.
[Dr Mike Patrick]
And then watching for those changes that we had mentioned previously, like, if they seem like they're not symmetrical, if one shoulder looks a little higher than the other, if they bend over and, you know, their back of their shoulder kind of humps up on one side. Once I think that that diagnosis is made, parents probably are a little bit more tuned in to those things than they may have been if, you know, you weren't really thinking about scoliosis to begin with. You may not notice those things until, you know, they're a little bit more severe.
Unless you're listening to this podcast and then you're going to start hopefully noticing that a little bit more. So, Allen, when does bracing become recommended and what is the goal of wearing a brace?
[Dr Allen Kadado]
Excellent question. So, bracing, the goal of bracing is to prevent scoliosis progression during those sensitive phases of rapid growth because we know that scoliosis progresses in those sensitive phases. Bracing is typically recommended in the moderate range of scoliosis.
Now, by definition, the moderate range is 25 to 45 degrees. So, if you're in the moderate range and you have growth remaining and you're in that sensitive growth phase, we may recommend a brace to prevent or slow scoliosis progression. The brace in itself is not good at making the scoliosis go away, that's not the goal, but we do, it is very helpful in preventing it from getting worse.
And the main goal, preventing it from getting it to a severe magnitude, at which point different management options are appropriate. Sometimes we brace in the mild range for scoliosis. So, under 25 degrees, you know, oftentimes anywhere between 17 to 25 degrees is what I would consider early bracing.
We think that's a very good option, particularly for those children who are in a very sensitive peak height velocity. So, the growth phase happens at a peak and then drops off. So, those kids that are at a peak, we may be more intentional about bracing sooner if we catch it sooner.
[Dr Mike Patrick]
And that's because when they're rapidly growing, that's also when the curve is most likely to get worse. And so, wearing that brace at that time may help to prevent that from progressing or maybe make it progress less than it otherwise would have without the brace.
[Dr Allen Kadado]
That is correct. And we have different options for bracing as well. Yeah.
[Dr Mike Patrick]
Now, we mentioned that the mild forms of scoliosis, and I'm talking in terms of the degree of the curve, typically don't cause any symptoms in terms of the child, like pain, you know, not being able to move as well or something. What about that middle road that you're talking about when we're thinking about bracing? Do you see symptoms at that point?
[Dr Allen Kadado]
So, physical symptoms in scoliosis in the mild to moderate are relatively rare. Now, with that, we are seeing plenty of symptoms and that's just related to a lot of children who have issues with back pain or discomforts and things like that. So, whether that's related to the actual spinal curvature or just related to activities and, you know, athletics or sedentary activity is the big question.
Can we see pain related to scoliosis in the moderate range? Absolutely. I would say we typically treat it very similar to a child without scoliosis, with the exception that we may introduce some physical activity programs that are scoliosis specific.
[Dr Mike Patrick]
Yeah, so through like physical therapy kind of thing?
[Dr Allen Kadado]
That's correct. We do offer here at Nationwide Children's a scoliosis-specific exercise program with physical therapy called SHROF, and that is a very specialized type of physical therapy for scoliosis. It helps with postural training, body awareness, breathing exercises, and we find it to be a nice option particularly for those mild to moderate range scoliosis, and I will say most commonly we use it as an adjunct to our bracing program.
[Dr Mike Patrick]
And I would imagine that the discomfort, if it's not coming from the curve of the spine itself, if your spine's not straight, you may be compensating as you're moving and being involved in activities from a muscle standpoint. So, you know, if things aren't center of gravity, I guess, and you are, you know, kind of thrown to one side or the other, you may use muscles in a different way than folks with a straight spine might, and then that could cause some muscle pain?
[Dr Allen Kadado]
Absolutely. I mean, us as humans, we love alignment and balance, you know, and it's my life mission to restore alignment and balance. So certainly, once you're out of balance or out of alignment, it is possible to have some asymmetric strains on muscles and things like that, but I will say in young resilient children and teenagers, they compensate quite well.
[Dr Mike Patrick]
And then we talked about wanting to still be involved in your normal activities and sports, and Crystal had mentioned we don't necessarily want to take kids out of sports, especially if that's something that they love, and it's certainly healthy to be active and outside and, you know, engaged in a sport where you're with other kids and all of those things. Are there some ways in which scoliosis or wearing that brace can affect school and sports in a child's daily life, Crystal?
[Crystal Seilhamer]
Yeah, it can. We typically will encourage the patient to even remove the brace for specific hours throughout the day so that they can participate in swimming or, you know, volleyball. You can't, those are very hard sports to do with a hard structured brace on, so we do allow those leniencies for kids to be able to remove the brace.
And depending on what type of brace they have, their daily prescription for how many hours they're in the brace is also different. But if it's a kid that's supposed to be in the brace for as many hours during the day as possible, like 18 to 20, we do say, please take the brace off so you can participate in activity. And then we also have them meet with our psychology team so that they can learn about how to talk to my friends about why I have this brace on at school or, you know, just kind of how to deal with the physical appearance changes that other kids are going to notice that they do have something different with them and the need to wear the brace.
[Dr Mike Patrick]
Yeah, and we know that's really difficult during the teenage years to be different in some way. Is that the psychology part of it? Do all the kids in your program see the psychologist or is that just something that you refer to psychology if they say they're having issues at school?
[Crystal Seilhamer]
So, the Wear a Brace program is set up now with speaking about bracing specifically, we do make the referral for every new prescription brace child to get a referral to psychology. A lot of times that's a telemedicine visit with the psychologist and then they are able to follow that patient along. And some patients are fine with it and able to not have quite so many appointments, but other kids really like talking about it and figuring out those, you know, those areas of concerns to help them feel more comfortable at school and with their friends.
[Dr Mike Patrick]
Yeah, yeah. I would imagine that, well, first let me say that's a great idea that everybody gets that referral because, you know, even if you're having difficulties, you know, maybe you're self-conscious about the brace or kids are making comments, you might not tell your parents that and you might not tell you guys that in the in the clinic. So, I think just universally making that referral does make a lot of sense.
And then the second thing is I think everybody ought to have a therapist anyway. So, you know, as you said they like those appointments and talking to someone about their life can certainly be helpful. Allen, when then is surgery considered for scoliosis and what should families know about that?
[Dr Allen Kadado]
Yeah, great question. So surgical management is reserved for the severe scoliosis. So typically, if you put a number on idiopathic scoliosis, it's beyond 45, 50 degrees or more.
Now the reasoning for surgery is not just that the curve has gotten bigger, but it's the risk of curve progression throughout the lifespan beyond skeletal maturity. So even when the child is done growing, because those curves have gotten bigger, we know from prior natural history studies, those curves do continue to progress throughout the lifespan. So, for that reason, the goal of surgery ends up being to prevent further progression beyond maturity.
Okay, at the same time we will restore alignment, but that's the main goal.
[Dr Mike Patrick]
Is to prevent worsening after you're done growing. Correct. And then what kind of what does that look like, the surgeries themselves?
I would imagine that it's complicated and there's lots of different options, but just in general, what do parents need to know about the procedure itself?
[Dr Allen Kadado]
Yeah, Dr. Mike, as you've alluded to, it does depend on the child, on the spinal characteristics specific to that child, their phase of growth, their goals. So, we take a full kind of holistic, comprehensive approach when deciding what surgical options to consider for that child. Most commonly, the most durable option in a nearing skeletally mature child or an adolescent is a poster spinal fusion.
So, the goal of that procedure is to stop further progression, restore the alignment, restore balance. It's a nice durable outcome. And typically, around surgery, you're about in the hospital for one or two nights after that surgery, you're up and walking either that same day of surgery or the day after working with physical therapy.
We have several colleagues that work with us in the hospital, including a pain team, psychology. Once the child is discharged home, you know, typically their instructions are just get up, move around, get your pain under control. Just avoid some terminal bending or twisting or lifting for a short period of time.
And then if everything goes well in the recovery period, by three months, those children are typically released to all activities without restriction, depending on their surgical procedures that they had done.
[Dr Mike Patrick]
And is there hardware left in the spine to keep it straight? Or is this something that you just use the bone? I am not a surgeon.
And so, there's a little bit of a black box in terms of what you guys exactly do.
[Dr Allen Kadado]
Yes. Yeah. Great question.
So, we use something called pedicle screws and rods. So, pedicle screws and rods in the spine, they anchor to the bone. And it's actually extremely powerful instrumentation, especially with the modern technology that we have.
We're able to correct spines quite a bit. So really nice option for restoration of alignment. So that's the most common option.
There are other options for treatment of scoliosis, in particular something called vertebral body tethering. It's more of a motion preservation option. That is a very special option for a very narrow population.
Children that are still growing or still have growth remaining because that option, it harnesses the growth of the spine in order to rebalance it over time. So, you need some growth left for that option. And you need to have a flexible curve and other characteristics as well.
So, a select population may be a candidate for that.
[Dr Mike Patrick]
And then, Crystal, how can parents best advocate for their child as they're journeying through scoliosis? As we had mentioned, this is really a long-term problem, not something that, oh, you see the orthopedic doctor, they fix it, you're done. This is really something that's going to be followed over time.
And so, parents may need at times to advocate for their child. What does that look like from the parent standpoint?
[Crystal Seilhamer]
Well, I really do think that that starts with the screening portion, even before they understand or know that they have scoliosis, advocating for the pediatrician to check their back. We talked to some families and they're like, oh, no one's ever looked at their back before. And then there's this gill of like, we should have caught it sooner and that kind of thing.
So, to me, advocating starts at the patient's well-child checks and making sure that healthcare provider is really assessing those kinds of signs and symptoms that we see. And then once a child has scoliosis, I think, you know, advocating for their child. Sometimes schools are, you know, once they hear the child has scoliosis, has questions about their participation and activities.
So just good communication with the school that they are able to stay active and involved in everything. And then really, you know, keeping compliance with their appointments and making sure that the orthopedic team is keeping good eyes on them. And we also have a lot of resources available to us now as providers and as patients and families.
So, whether a child is braced or whether they just have a brand-new scoliosis diagnosis, we have a lot of resources that are even available on our Nationwide Children's Hospital orthopedic page. Families can go to and get many, many questions answered.
[Dr Mike Patrick]
And we will have links to a lot of the resources that you mentioned. The Center for Comprehensive Spine Care at Nationwide Children's Hospital. Lots of stuff there.
And we'll have a link in the show notes. This is episode 596 over at pediacast.org. We'll also have some articles from the Scoliosis Research Society and in particular, What is Scoliosis?
Also, the Setting Scoliosis Straight, folks. So again, lots of resources out there and we're going to have links to them. Another one from the Pediatric Orthopedic Society of North America, the Pediatric Spine Foundation.
And then there's this thing called Higgy Bears, making scoliosis bearable. What exactly is that? What are the Higgy Bears?
[Crystal Seilhamer]
So, I know there's not a video on right now, but we do have bears that families are able to obtain that have braces on them. And especially, you know, even the teenagers like these bears that they can hold and really like kind of play with, but really like the younger kids, too. It's really helpful in explaining the brace and understanding that other kids are also in braces, not just them.
[Dr Mike Patrick]
Yeah, yeah. And I can verify that the Higgy Bear is very cute. And so, this is a great reason to go to pediacast.org, look for episode 596 and to click on that link, Higgy Bears, making scoliosis bearable. So once again, Dr. Allen Kadado, Pediatric Orthopedic Surgeon at Nationwide Children's Hospital and Crystal Seilhamer, Nurse Practitioner and Program Coordinator with the Center for Comprehensive Spine Care at Nationwide Children's. Thank you both so much for stopping by today.
[Dr Allen Kadado]
Thank you, Dr. Mike, for having us.
[Crystal Seilhamer]
Yes, thank you, Dr. Mike.
[Music]
[Dr Mike Patrick]
We are back with just enough time to say thanks once again to all of you for taking time out of your day and making PediaCast a part of it. We really appreciate your support. Also, thanks again to our guests this week, Dr. Allen Kadado, Pediatric Orthopedic Surgeon at Nationwide Children's and Crystal Seilhamer, Nurse Practitioner and Program Coordinator at the Center for Comprehensive Spine Care. Don't forget, you can find PediaCast wherever podcasts are found or in the Apple Podcast app, Spotify, iHeartRadio, Amazon Music, Audible, YouTube, and most other podcast apps for iOS and Android. Our landing site is pediacast.org. You'll find our entire archive of past programs there, along with show notes for each of the episodes, our terms of use agreement, and that contact page if you would like to suggest a future topic for the program, or if you just want to reach out and say hi.
I love hearing from the audience, and you can reach me at that contact page. Reviews are also helpful wherever you get your podcasts. We always appreciate when you share your thoughts about the show, and we love connecting with you on social media.
You'll find us on Facebook, Instagram, Threads, LinkedIn, X, and Blue Sky. Simply search for PediaCast. A couple of other podcasts that I host, one is PediaCast CME.
That stands for Continuing Medical Education. It is similar to this program. We do turn the science up a couple notches, and we offer free Category 1 Continuing Medical Education credit for those who listen.
And that's not only for doctors, but also nurse practitioners, physician assistants, nurses, pharmacists, psychologists, social workers, and dentists. And it is because Nationwide Children's is jointly accredited by all of those professional organizations that it's likely we offer the exact credit you need to fulfill your state's continuing medical education requirements. Shows and details are available at the landing site for that program, pediacastcme.org.
You can also listen wherever podcasts are found. Simply search for PediaCast CME. And then I also host FAMEcast.
This is a faculty development podcast from the Center for Faculty Advancement, Mentoring, and Engagement at the Ohio State University College of Medicine. So, if you are a teacher in academic medicine or a faculty member in any of the health sciences, then this is a podcast for you. And you can find FAMEcast at famecast.org and wherever podcasts are found by searching for, you got it, FAMEcast. Thanks again for stopping by. And until next time, this is Dr. Mike saying, stay safe, stay healthy, and stay involved with your kids. So long, everybody.
[Music]
