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For In-Depth information on scoliosis, click here.
Definition
Scoliosis is a sideways curve of the spine, or backbone.
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Causes
In most cases, the cause of scoliosis is not known. It usually develops in childhood before puberty, though it may not be diagnosed until the teen years. Scoliosis is classified based on the age at diagnosis:
- Adolescent scoliosis — 11-17 years old
- Juvenile scoliosis — 3-10 years old
- Infantile scoliosis — younger than 3 years old. This form may result from:
- Birth defects
- Diseases of the nerves and muscles (muscular dystrophy or cerebral palsy)
- Injury
- Infection
- Tumors
Occasionally, the spine curvature of scoliosis is due to a muscle imbalance rather than a spinal deformity.
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Risk Factors
A risk factor is something that increases your chance of getting a disease or condition.
- Age: Adolescent years (after age 10)
- Family members who have had scoliosis
- Delayed puberty and menarche in girls
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Symptoms
Symptoms include:
- Uneven shoulders
- Prominent shoulder blade or ribs
- Uneven waist
- Elevated hips
- Leaning to one side
- Chronic back pain (usually only if left untreated for several years)
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Diagnosis
The doctor will ask about your symptoms and medical history, and perform a physical exam. The doctor will examine the following for curves or asymmetry:
- Back
- Shoulders
- Chest
- Pelvis
- Legs
- Feet
- Skin
Other tests and diagnostic methods may include:
X-ray
The doctor may recommend an X-ray if you have significant spinal curves, unusual back pain, or signs of brain and spinal cord problems. Occasionally, more tests are needed.
Curve Measurement
The doctor estimates the angle of the curve. In general, curves that are greater than 20 degrees require treatment. Doctors classify curves of the spine by their location, shape, pattern, and cause. They use this information to decide how to treat the scoliosis.
Referral to a Spine Doctor
Your doctor may refer you to an orthopedic spine specialist, a doctor who has experience treating people with scoliosis.
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Treatment
Children with mild spinal curves generally do not need treatment. The type of treatment depends on:
- Your age
- How much more you are likely to grow
- The degree and pattern of the curve
- If you have back pain
Treatment options include:
Observation
Your doctor will probably just monitor the curve by examining you every 3 to 6 months if your curve is less than 20 degrees or if you are almost done growing.
Bracing
The goal of bracing is to prevent curves from getting worse. Your doctor may recommend that you wear a back brace if you are still growing and your curve is more than 20 degrees. Once you stop growing, the need for more treatment will depend on the size of the curve and how it affects your appearance and function.
Surgery
In severe cases, your doctor may recommend surgery to correct a curve or stop it from worsening if you are still growing.
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Prevention
There are no guidelines for preventing scoliosis, because the cause is usually not known. Some schools have scoliosis screening programs to detect scoliosis, usually in the fifth or sixth grade. If scoliosis is detected in school, you will be advised to follow up with your doctor.
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