Scoliosis is an abnormal curvature of the spine. The normal
shape of a person’s spine includes a curve at the top of the shoulder and a curve
at the lower back. If your spine is curved from side to side or in an “S” or
“C” shape, you might have scoliosis.
According to the American
Association of Neurological Surgeons (AANS), about 80 percent of scoliosis
cases have no identifiable cause. The condition is often diagnosed during the
first seven years of a child’s life. Common causes, when they can be pinpointed,
- birth defects
- neurological abnormalities
- genetic conditions
What are the common types of scoliosis?
The largest category of scoliosis is idiopathic scoliosis, a
term used to refer to cases that have no definite cause. Idiopathic scoliosis
is broken down by age group:
- infant: 0 to 3 years
- juvenile: 4 to 10 years
- adolescent: 11 to 18 years
- adult: 18+ years
Of these, adolescent idiopathic scoliosis is the most common,
according to the AANS.
Doctors identify a cause for an estimated 20 percent of scoliosis
cases. These consist of different types of scoliosis, including:
- congenital, in which spinal
deformities are apparent at birth
- neurological, when nerve
abnormalities affect muscles in the spine
Scoliosis can also be categorized as either structural or
nonstructural. In structural scoliosis, the spine’s curve is caused by a
disease, injury, or birth defect, and is permanent. Nonstructural scoliosis describes
temporary curves that can be fixed.
What are the symptoms of scoliosis?
Symptoms vary depending on the degree of scoliosis. Common
symptoms associated with scoliosis include:
- one shoulder blade that is higher than the other
- one shoulder blade that sticks out more than the
- uneven hips
- a rotating spine
- problems breathing because of reduced area in
the chest for lungs to expand
- back pain
What causes scoliosis?
The cause of scoliosis often can’t be determined. Common
causes that doctors may identify include:
- cerebral palsy, a
group of nervous system disorders that affect movement, learning, hearing,
seeing, and thinking
dystrophy, a group of genetic disorders that result in muscle weakness
- birth defects that affect an infant’s spinal
bones, such as spina bifida
- spinal injuries or infections
People with a family history of scoliosis are more likely to
develop the condition. Girls are more likely to have a more severe form of
scoliosis than boys.
How is scoliosis diagnosed?
A physical exam of your spine is the first step your doctor
takes to see if you have scoliosis. Your doctor may also order some imaging
tests to get a closer look at your spine.
Your doctor will observe your back while you stand with your
arms at your sides. They’ll check for spine curvature and whether your
shoulders and waist area are symmetrical. Next, your doctor will ask you to
bend forward, looking for any curvature in your upper and lower back.
Imaging tests your doctor may order to look for scoliosis include:
- X-ray: uses small amounts of radiation to create a picture of your
- MRI scan:
uses radio and magnetic waves to get a detailed picture of bones and the
tissue surrounding them
- CT scan: takes X-rays
at a variety of angles to get a 3-D picture of the body
- bone scan: detects
a radioactive solution injected into your blood that concentrates in areas of
increased circulation, highlighting spinal abnormalities
What are the treatment options for scoliosis?
Treatment depends on numerous factors, the degree of spine
curvature being a major one. Your doctor will also take into consideration:
- your age
- whether you are likely to continue growing
- the amount and type of curvature
- the type of the scoliosis
The primary treatment options are bracing and surgery.
According to the National
Institute of Arthritis and Musculoskeletal and Skin Diseases, a person with
scoliosis may need to use a brace if:
- They’re still growing and the curvature is more
than 25 to 30 degrees.
- They’re still growing and the curvature is
between 20 and 29 degrees, but the curvature is getting worse.
- The curvature is between 20 and 29 degrees and the
person has at least two more years to grow (also applies to girls who haven’t
Braces won’t straighten the spine, but they can prevent the
curvature from increasing. This method of treatment is more effective for cases
that are detected early.
Those requiring a brace need to wear it 24 hours a day for
maximum effectiveness. As an exception, children may remove their braces to
participate in exercise and sports activities.
Doctors usually recommend that children wear their braces
until they reach adolescence and are no longer growing.
There are two main types of braces:
Made of plastic and fitting close to the body, this brace is virtually
invisible. It’s used to treat lower spine curves and fits around the lower part
of the body.
This brace starts at the neck and covers the entire torso, with the exception
of the legs and arms. It’s used for curves that the underarm brace can’t address.
Surgery is usually reserved for people with curves greater
than 45 or 50 degrees. However, talk to your doctor about this option if you’ve
been diagnosed with scoliosis and feel the curvature is interrupting your daily
life or causing you discomfort.
is the standard scoliosis surgery. In this procedure, the doctor fuses your
vertebrae together using a bone graft, rods, and screws. The bone graft
consists of bone or a material like it. The rods keep your spine in a straight
position, and the screws hold them in place. Eventually, the bone graft and
vertebrae fuse into a single bone. Rods can be adjusted in children as they
Some of the risks of spinal fusion surgery include:
- excessive bleeding
- failure to heal
- nerve damage
What is the long-term outlook for scoliosis?
The long-term outlook for scoliosis depends on how severe
the curvature is. For mild to moderate cases, the condition won’t interfere
with everyday activities and functions. Individuals with severe forms of
scoliosis may have physical limitations.
Living with scoliosis can be difficult. If you’re looking
for help managing your scoliosis, you may want to seek out a support group. Support
groups allow you to meet others who are experiencing the same things, and you
can find encouragement and advice about dealing with the condition on a daily
The National Scoliosis
Foundation is a good starting point for finding resources.