Scoliosis is a common spine condition that can occur at any age, but it is most often is diagnosed in adolescents. The short definition of scoliosis is a spinal curve greater than 10 degrees.
Some common physical findings that may indicate scoliosis include uneven shoulders, a visible spine curve, or uneven hips. In the United States, approximately 2-3% of the population has a diagnosis of scoliosis, which corresponds to about 6 million people. The overwhelmingly majority of cases, approximately 80%, are diagnosed as idiopathic scoliosis that typically presents in adolescent children, mostly females, between 10 and 12 years of age.
It is important to understand that the majority of scoliosis cases have no known cause and parents must be aware that there is no method of prevention. Common misconceptions are that external factors such as heavy backpacks, poor posture, or contact sports can cause scoliosis. Although these factors can contribute to pain or other back problems, they are not known risk factors for the development of idiopathic scoliosis. If you have relatives who have scoliosis, you are more likely to develop it. So it’s important to discuss family history with your child’s clinician as this will play an important factor in evaluation and treatment.
Idiopathic scoliosis curves typically worsen during times of rapid growth and development. Since growth spurts can vary based on a child’s age, gender and other underlying medical conditions, regular physical exams with your primary care clinician are crucial.
A common assumption by many parents and children is that once diagnosed, their scoliosis requires treatment. It is important to understand that a small percentage require interventions beyond regular checkups with x-rays.
If scoliosis is diagnosed and follow-up examinations show progression, there are multiple non-operative treatments that can help to prevent the curve from progressing and possibly prevent the need for surgical intervention. Treatments can include custom external torso bracing to support the spine during rapid growth and specialized forms of physical therapy to help with long-term core strength and stability. It is important to know that these non-operative interventions attempt to halt progression of the scoliosis while a child is growing, not cure it.
If a brace is needed, it is temporary. Almost all children live normal lives during bracing and participate in their previous activities, sports, and hobbies. In some rare cases, if either bracing is not effective or the scoliosis is severe at diagnosis, interventional treatments may be recommended. Spine surgery occurs in less than 10% of children that require interventions such as bracing. It is important to know that there have been many advances over the last decade in scoliosis surgical management and outcomes are overwhelmingly good.
If you do notice any signs or symptoms of scoliosis in your child or have a strong family history, it is very important to discuss this with your child’s primary care physician. Early diagnosis leads to early treatment, which will allow your child to have the best possible chance at controlling curve progression.
Dr. Raman Singh is a Pediatric Sports Medicine physician who has extensive experience in non-operative management of scoliosis. His team works closely with local pediatric spine surgeons, physical therapist, orthotists, and radiologist in the community to ensure your child has the best care.