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Scoliosis

Definition

Scoliosis is an abnormal curving of the spine. Your spine is your backbone. It runs straight down your back. Everyone’s spine naturally curves a bit. But people with scoliosis have a spine that curves too much. The spine might look like the letter C or S.

Alternative Names

Spinal curvature; Infantile scoliosis; Juvenile scoliosis

Causes

Most of the time, the cause of scoliosis is unknown. This is called idiopathic scoliosis. It is the most common type. It is grouped by age.

Scoliosis most often affects girls. Some people are more likely to have curving of the spine. Curving generally gets worse during a growth spurt.

Other types of scoliosis are:

Symptoms

Usually there are no symptoms.

If there are symptoms, they may include:

Exams and Tests

The health care provider will perform a physical exam. You will be asked to bend forward. This makes your spine easier to see. It may be hard to see changes in the early stages of scoliosis.

 The exam may show:

X-rays of the spine are done. X-rays are important because the actual curving of the spine may be worse than what your doctor can see during an exam.

Other tests may include:

Treatment

Treatment depends on many things:

Most people with idiopathic scoliosis do not need treatment. But you should still be checked by a doctor about every 6 months.

If you are still growing, your doctor might recommend a back brace. A back brace prevents further curving. There are many different types of braces. What kind you get depends on the size and location of your curve. Your health care provider will pick the best one for you and show you how to use it. Back braces can be adjusted as you grow.

Back braces work best in people over age 10. Braces do not work for those with congenital or neuromuscular scoliosis. 

Sometimes, surgery is needed:

After surgery, you may need to wear a brace for a while to keep the spine still.

You may need surgery if the spine curve is severe or getting worse very quickly. The surgeon may want to wait until all your bones stop growing, but this is not always possible.

Scoliosis treatment may also include:

Support Groups

Seek support and more information from organizations that specialize in scoliosis.

Outlook (Prognosis)

How well  a person with scoliosis does depends on the type, cause, and severity of the curve. The more severe the curving, the more likely it will get worse after the child stops growing.

People with mild scoliosis do well with braces. They usually do not have long-term problems.  Back pain may be more likely when the person gets older.

Outlook for those with neuromuscular or congenital scoliosis varies. They may have another serious disorder such as cerebral palsy or muscular dystrophy, so their goals are much different. Often the goal of surgery is simply to allow a child to be able to sit upright in a wheelchair.

Congenital scoliosis is difficult to treat and usually requires many surgeries.

Possible Complications

Complications of scoliosis can include:

When to Contact a Medical Professional

Call your health care provider if you suspect your child may have scoliosis.

Prevention

Routine scoliosis screening is now done in middle schools.

Such screening has helped detect early scoliosis in many children.

References

Thomas MA, Wang Y. Scoliosis and kyphosis. In: Frontera, WR, Silver JK, Rizzo TD Jr, eds. Essentials of Physical Medicine and Rehabilitation. 2nd ed. Philadelphia, Pa: Elsevier Saunders; 2008:chap 143.

Warner WC, Sawyer JR, Kelly DM. Scoliosis and kyphosis. In: Canale ST, Beaty JH, eds. Campbell’s Operative Orthopaedics. Philadelphia, Pa: Elsevier Mosby; 2012:chap 41.



Review Date: 8/22/2013
Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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