Scoliosis

Overview

What Is Scoliosis?

Scoliosis (sko-lee-OH-sis)  is when the spine curves sideways instead of being straight. Although the spine is sometimes called "the backbone," it's not just one bone. It's made of lots of small bones (called vertebrae) that are connected by a type of elastic tissue called cartilage. This gives people the flexibility to bend, stretch, balance, and even walk. In scoliosis, the vertebrae form a curved line instead, and sometimes they also rotate (twist), like a corkscrew.

Small curves usually don't cause problems. But a curve that gets worse during rapid periods of growth can cause noticeable changes in posture — like uneven shoulders, a prominent shoulder blade, or hips that don't sit level. In some cases, it can put pressure on the lungs or heart, making it harder to breathe or stay active. If needed, healthcare providers may treat scoliosis with a back brace. In severe cases, they may recommend surgery for large curves in the spine.

What Are the Types of Scoliosis?

Orthopedic specialists group scoliosis into types. Knowing the type of scoliosis helps them decide how to treat it.

• Idiopathic scoliosis. This is the most common type of scoliosis. Kids can get it at any age, but most of the time it happens around puberty when a child goes through a growth spurt. Experts don't know exactly why this type of scoliosis develops, but it runs in some families.
• Congenital scoliosis. This type of scoliosis happens when something goes wrong with the way vertebrae develop before a baby is born. The problem might not be noticed until a child goes through a growth spurt, usually around age 2 or between 8 and 13.
• Scoliosis caused by a medical condition. Some kids develop scoliosis because they have a long-term medical problem that affects the muscles or skeletal system. For example, kids with muscular dystrophy, cerebral palsy, Marfan syndrome, or osteogenesis imperfecta may get scoliosis. Kids who have had tumors or growths on their spine may also develop scoliosis. Kids with a history of heart surgery or chest surgery may also be at risk for scoliosis.

Signs & Symptoms

What Are the Signs & Symptoms of Scoliosis?

Sometimes scoliosis is easy to see. A curve in the spine can make the body shift to the left or right. If you have scoliosis, it might look like you are leaning to one side. Some people have one shoulder higher than the other or one shoulder blade that sticks out more than the other. If your spine is twisted, one side of your ribcage might stick out more when you bend over.

Often, scoliosis isn't obvious. That's why healthcare providers do scoliosis exams during regular checkups. Some states have school-based scoliosis screening programs.

Small curves usually don't cause problems. But a curve that gets worse can be harmful for a person's health. Very large curves can damage the joints and cause arthritis of the spine. Large curves can make the ribs rub against the pelvis, causing pain. Someone with a severe curve in their spine may even develop heart or lung problems.

When to Call a Doctor

Sometimes scoliosis doesn’t have obvious symptoms but is caught at your child’s annual check-up or at a school health screening. But call your pediatrician if your child experiences:

• pain in their back, shoulders, or rib cage
• pain that limits their activities
• a tilt to one side when standing
• a ribcage that sticks out when they bend over
• other back pain
• trouble breathing or shortness of breath
• neurological problems like neck pain, muscle or nerve weakness, bowel or bladder problems, or headache

Causes

What Causes Scoliosis?

There isn’t a single cause of scoliosis. It can develop for a variety of reasons.

• It can occur in puberty when a child goes through a growth spurt.
• Sometimes it runs in families.
• It can happen during pregnancy when something goes wrong with the way some vertebrae develop.
• It can be caused by a medical condition that affects the muscles or skeletal system.
• It can develop in kids who have had tumors or growths on their spine.

Treatment & Care

How Is Scoliosis Treated?

Children with small curves may only require checkups once or twice a year to make sure the problem isn’t getting worse.

Healthcare providers will keep an eye on large curves by doing X-rays. They might decide to treat the scoliosis with bracing or surgery. The treatment used depends on the type of scoliosis and how much more a child will grow.

What Else Should I Know?

There's no quick fix for scoliosis. Wearing a brace or recovering from surgery may be challenging. But when treatment is over, people with scoliosis can live full and active lives.