Scoliosis is a sideways curvature of the spine that most often is diagnosed in adolescents. While scoliosis can occur in people with conditions such as cerebral palsy and muscular dystrophy, the cause of most childhood scoliosis is not known.
Most cases of scoliosis are mild, but some curves worsen as children grow. Severe scoliosis can be disabling. An especially serious spinal curve can reduce the amount of space within the chest, making it difficult for the lungs to function properly.
Children who have mild scoliosis are monitored closely, usually with X-rays, to see if the curve is getting worse. In many cases, no treatment is necessary. Some children may need to wear a brace to stop the curve from worsening. Others may need surgery to straighten more serious curves.
Symptoms of scoliosis may include:
With most scoliosis cases, the spine will rotate or twist in addition to curving side to side. This causes the ribs or muscles on one side of the body to stick out farther than those on the other side.
Go to your health care provider if you notice signs of scoliosis in your child. Mild curves can develop without you or your child knowing it because they appear gradually and usually don't cause pain. Occasionally, teachers, friends and sports teammates are the first to notice a child's scoliosis.
Health care providers don't know what causes the most common type of scoliosis — although it appears to involve hereditary factors, because the disorder sometimes runs in families. Less common types of scoliosis may be caused by:
Risk factors for developing the most common type of scoliosis include:
While most people with scoliosis have a mild form of the disorder, scoliosis may sometimes cause complications, including:
The health care team will initially take a detailed medical history and may ask questions about recent growth. During the physical exam, your provider may have your child stand and then bend forward from the waist, with arms hanging loosely, to see if one side of the rib cage is more prominent than the other.
Your provider also may perform a neurological exam to check for:
Plain X-rays can confirm the diagnosis of scoliosis and reveal the seriousness of the spinal curvature. Repeated radiation exposure can become a concern because multiple X-rays will be taken over the years to see if the curve is worsening.
To reduce this risk, your health care provider might suggest a type of imaging system that uses lower doses of radiation to create a 3D model of the spine. However, this system isn't available at all medical centers. Ultrasound is another option, although it can be less precise in determining the seriousness of the scoliosis curve.
Magnetic resonance imaging (MRI) might be recommended if your health care provider suspects that an underlying condition — such as a spinal cord irregularity — is causing the scoliosis.
Scoliosis treatments vary, depending on the size of the curve. Children who have very mild curves usually don't need any treatment at all, although they may need regular checkups to see if the curve is worsening as they grow.
Bracing or surgery may be needed if the spinal curve is moderate or large. Factors to be considered include:
If your child has moderate scoliosis and the bones are still growing, your health care provider may recommend a brace. Wearing a brace won't cure scoliosis or reverse the curve, but it usually prevents the curve from getting worse.
The most common type of brace is made of plastic and is contoured to conform to the body. This brace is almost invisible under the clothes, as it fits under the arms and around the rib cage, lower back and hips.
Most braces are worn between 13 and 16 hours a day. A brace's effectiveness increases with the number of hours a day it's worn. Children who wear braces can usually participate in most activities and have few restrictions. If necessary, a child can take off the brace to participate in sports or other physical activities.
Braces are discontinued when there are no further changes in height. On average, girls complete their growth at age 14, and boys at 16, but this varies greatly by individual.
Severe scoliosis typically progresses with time, so your health care provider might suggest scoliosis surgery to help straighten the curve and prevent it from getting worse.
Surgical options include:
Complications of spinal surgery may include bleeding, infection or nerve damage.
There are no specific activities that are known to cause or correct scoliosis. In general, people with scoliosis have no restrictions regarding lifting or activities. General exercise or participating in sports may have the benefit of improving overall health and well-being.
Studies indicate that the following treatments for scoliosis don't help correct the curve:
Coping with scoliosis can be difficult for a young person in an already complicated stage of life. Teens are bombarded with physical changes and emotional and social challenges. With the added diagnosis of scoliosis, adolescents may feel anger, insecurity and fear.
A strong, supportive peer group can have a significant impact on a child's or teen's acceptance of scoliosis, bracing or surgical treatment. Encourage your child to talk to friends and ask for their support.
Consider joining a support group for parents and kids with scoliosis. Support group members can provide advice, relay real-life experiences and help you connect with others facing similar challenges.
Your child's health care team may check for scoliosis at a routine well-child visit. Many schools also have screening programs for scoliosis. Physical examinations prior to sports participation often detect scoliosis. If you are informed that your child might have scoliosis, see your health care provider to confirm the condition.
Before the appointment, write a list that includes:
Your health care provider may ask some of the following questions:
