Main Campus: Chesterfield, MO 63017 | 
Scoliosis
Spinal curvature; Infantile scoliosis; Juvenile scoliosis
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.
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.
- In children age 3 and younger, it is called infantile scoliosis.
- In children age 4 through 10, it is called juvenile scoliosis.
- In children age 11 through 18, it is called adolescent scoliosis.
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:
- Congenital scoliosis: This type of scoliosis is present at birth. It occurs when the baby’s ribs or spine bones do not form properly.
-
Neuromuscular scoliosis: This type is caused by a nervous system problem that affects the muscles. Problems can include
cerebral palsy
,
muscular dystrophy
, spina bifida, and
polio
.
Cerebral palsy
Cerebral palsy is a group of disorders that can involve brain and nervous system functions, such as movement, learning, hearing, seeing, and thinking...
ImageRead Article Now Book Mark ArticleMuscular dystrophy
Muscular dystrophy is a group of inherited disorders that cause muscle weakness and loss of muscle tissue, which get worse over time.
ImageRead Article Now Book Mark ArticlePolio
Polio is a viral disease that can affect nerves and can lead to partial or full paralysis. The medical name for polio is poliomyelitis.
ImageRead Article Now Book Mark Article
Symptoms
Most often, there are no symptoms.
If there are symptoms, they may include:
- Backache or low-back pain
- Tired feeling in the spine after sitting or standing for a long time
- Uneven hips or shoulders (one shoulder may be higher than the other)
- Spine curves more to one side
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:
- One shoulder is higher than the other
- The pelvis is tilted
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:
- Spinal curve measurement (scoliometer screening)
-
MRI
of the spine
MRI
A magnetic resonance imaging (MRI) scan is an imaging test that uses powerful magnets and radio waves to create pictures of the body. It does not us...
ImageRead Article Now Book Mark Article
Treatment
Treatment depends on many things:
- The cause of scoliosis
- Where the curve is in your spine
- How big the curve is
- If your body is still growing
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 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.
You may need surgery if the spine curve is severe or getting worse very quickly.
Surgery
Scoliosis surgery repairs abnormal curving of the spine (scoliosis). The goal is to safely straighten your child's spine and align your child's shou...
Surgery involves correcting the curve as much as possible:
- Surgery is done with a cut through the back, belly area, or beneath the ribs.
- The spine bones are held in place with 1 or 2 metal rods. The rods are held down with hooks and screws until the bone heals together.
- After surgery, you may need to wear a brace for a while to keep the spine still.
Scoliosis treatment may also include:
- Emotional support: Some children, especially teens, may be self-conscious when using a back brace.
- Physical therapy and other specialists to help explain the treatments and make sure the brace fits correctly.
Support Groups
Seek support and more information from organizations that specialize in scoliosis .
Organizations that specialize in scolio...
The following organizations are good resources for information on scoliosis:American Academy of Orthopedic Surgeons -- orthoinfo. aaos. org/topic. cf...
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:
- Breathing problems (in severe scoliosis)
- Low back pain
- Lower self-esteem
- Persistent pain if there is wear and tear of the spine bones
- Spinal infection after surgery
- Spine or nerve damage from an uncorrected curve or spinal surgery
When to Contact a Medical Professional
Call your 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
Mistovich RJ, Spiegel DA. The spine. In: Kliegman RM, Stanton BF, St Geme JW III, Schor NF, eds. Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; 2016:chap 679.
Richards BS, Sucato DJ, Johnston CE. Scoliosis. In: Herring JA, ed. Tachdjian's Pediatric Orthopaedics . 5th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 12.
Thomas MA, Therattil M. Scoliosis and kyphosis. In: Frontera WR, Silver JK, Rizzo TD Jr, eds. Essentials of Physical Medicine and Rehabilitation: Musculoskeletal Disorders, Pain, and Rehabilitation . 3rd ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 152.
-
Scoliosis - illustration
Abnormal curvature in the spine is known as scoliosis, and generally begins just at the onset of puberty and progresses during the period of rapid growth. Most junior high schools routinely screen for scoliosis because, if caught early, progressive spine curvature can be prevented. Scoliosis affects girls much more frequently than boys.
Scoliosis
illustration
-
Skeletal spine - illustration
The spine is divided into several sections. The cervical vertebrae make up the neck. The thoracic vertebrae comprise the chest section and have ribs attached. The lumbar vertebrae are the remaining vertebrae below the last thoracic bone and the top of the sacrum. The sacral vertebrae are caged within the bones of the pelvis, and the coccyx represents the terminal vertebrae or vestigial tail.
Skeletal spine
illustration
-
Scoliosis - illustration
Lateral curvature of the spine, scoliosis, is a relatively common condition. The majority of individuals with scoliosis do not require surgery or braces because their condition is self-limiting. Progressive scoliosis, however, requires therapy. The "S" shaped curve is usually more apparent on an X-ray.
Scoliosis
illustration
-
Spinal curves - illustration
There are four natural curves in the spinal column. The cervical, thoracic, lumbar, and sacral curvature. The curves, along with the intervertebral disks, help to absorb and distribute stresses that occur from everyday activities such as walking or from more intense activities such as running and jumping.
Spinal curves
illustration
-
Signs of scoliosis - illustration
Scoliosis may be suspected when one shoulder appears to be higher than the other, there is a curvature in the spine, or the pelvis appears to be tilted. The treatment of scoliosis can involve the use of a brace or surgery. Treatment is determined by the cause of the scoliosis, the size and location of the curve, and the stage of bone growth of the patient.
Signs of scoliosis
illustration
-
Forward bend test - illustration
The forward bend test is a test used most often in schools and doctor's offices to screen for scoliosis. During the test, the child bends forward with the feet together and knees straight while dangling the arms. Any imbalances in the rib cage or other deformities along the back could be a sign of scoliosis.
Forward bend test
illustration
-
Scoliosis brace - illustration
One type of treatment for scoliosis is the use of a brace. The brace works by exerting pressure on the back and ribs to push the spine in a straighter position. The brace usually fits snugly around the torso and can come in many styles. In a child who is still growing, bracing is usually recommended to help slow the progression of the curve. The brace is usually worn full-time until the growth of the bones has stopped.
Scoliosis brace
illustration
-
Spinal fusion - illustration
Depending upon the severity and responsiveness to other treatment surgery may be recommended for the scoliosis. Surgical correction involves correcting the curve (although not all the way) and fusing the bones in the curve together. Bone grafts are laid across the exposed surface of each vertebra. These grafts will regenerate, grow into the bone, and fuse the vertebrae together. The bones are held in place with one or two metal rods held down with hooks and screws, which also helps to support the fusion of the vertebrae.
Spinal fusion
illustration
-
Scoliosis - illustration
Abnormal curvature in the spine is known as scoliosis, and generally begins just at the onset of puberty and progresses during the period of rapid growth. Most junior high schools routinely screen for scoliosis because, if caught early, progressive spine curvature can be prevented. Scoliosis affects girls much more frequently than boys.
Scoliosis
illustration
-
Skeletal spine - illustration
The spine is divided into several sections. The cervical vertebrae make up the neck. The thoracic vertebrae comprise the chest section and have ribs attached. The lumbar vertebrae are the remaining vertebrae below the last thoracic bone and the top of the sacrum. The sacral vertebrae are caged within the bones of the pelvis, and the coccyx represents the terminal vertebrae or vestigial tail.
Skeletal spine
illustration
-
Scoliosis - illustration
Lateral curvature of the spine, scoliosis, is a relatively common condition. The majority of individuals with scoliosis do not require surgery or braces because their condition is self-limiting. Progressive scoliosis, however, requires therapy. The "S" shaped curve is usually more apparent on an X-ray.
Scoliosis
illustration
-
Spinal curves - illustration
There are four natural curves in the spinal column. The cervical, thoracic, lumbar, and sacral curvature. The curves, along with the intervertebral disks, help to absorb and distribute stresses that occur from everyday activities such as walking or from more intense activities such as running and jumping.
Spinal curves
illustration
-
Signs of scoliosis - illustration
Scoliosis may be suspected when one shoulder appears to be higher than the other, there is a curvature in the spine, or the pelvis appears to be tilted. The treatment of scoliosis can involve the use of a brace or surgery. Treatment is determined by the cause of the scoliosis, the size and location of the curve, and the stage of bone growth of the patient.
Signs of scoliosis
illustration
-
Forward bend test - illustration
The forward bend test is a test used most often in schools and doctor's offices to screen for scoliosis. During the test, the child bends forward with the feet together and knees straight while dangling the arms. Any imbalances in the rib cage or other deformities along the back could be a sign of scoliosis.
Forward bend test
illustration
-
Scoliosis brace - illustration
One type of treatment for scoliosis is the use of a brace. The brace works by exerting pressure on the back and ribs to push the spine in a straighter position. The brace usually fits snugly around the torso and can come in many styles. In a child who is still growing, bracing is usually recommended to help slow the progression of the curve. The brace is usually worn full-time until the growth of the bones has stopped.
Scoliosis brace
illustration
-
Spinal fusion - illustration
Depending upon the severity and responsiveness to other treatment surgery may be recommended for the scoliosis. Surgical correction involves correcting the curve (although not all the way) and fusing the bones in the curve together. Bone grafts are laid across the exposed surface of each vertebra. These grafts will regenerate, grow into the bone, and fuse the vertebrae together. The bones are held in place with one or two metal rods held down with hooks and screws, which also helps to support the fusion of the vertebrae.
Spinal fusion
illustration
-
Scoliosis
(In-Depth)
Review Date: 7/10/2015
Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
