What Is Idiopathic Scoliosis?
People with scoliosis have a side-to-side curve in the spine that can look like an "S" or a "C." In addition, some of the bones (vertebrae) in the back can rotate, making the spine twist.
Small curves usually don't cause problems. But a curve that gets worse can cause pain and health problems. Very large curves can damage the joints, causing back pain or arthritis of the spine. If the spine curves a lot, people might get lung problems.
Kids of any age — even infants — can have idiopathic scoliosis (sko-lee-OH-sis). But it's usually found when a child begins going through puberty.
What Causes Idiopathic Scoliosis?
Idiopathic scoliosis is a bit of a medical mystery. “Idiopathic” means “from an unknown cause.” No one knows for sure why kids get it, but research shows that it runs in families.
The condition isn't caused by things like carrying a heavy backpack, bad posture, playing sports — or anything else kids might do. Kids don't have control over whether they get scoliosis. It's in their genes.
What Are the Signs & Symptoms of Scoliosis?
Sometimes scoliosis is easy to see. A curve in the spine can make the trunk shift to the left or right. Kids might look like they are leaning to one side. Some kids might have one shoulder higher than the other or one shoulder blade that sticks out more than the other. If the spine is twisted, one side of the ribcage might stick out more when a child bends over.
Often, scoliosis isn't obvious. That's why health care providers do a scoliosis exam as part of a child's regular checkup. Some states have school-based scoliosis screening programs.
How Is Scoliosis Diagnosed?
If you think your child has scoliosis, make an appointment with your health care provider. Because idiopathic scoliosis can run in families, the care provider will ask questions about your medical history to help make a diagnosis.
The health care provider will examine your child, and may refer you to an orthopedic specialist. These experts treat diseases of the bones and muscles. They see lots of kids with scoliosis and can decide if a child needs treatment. Either your primary health care provider or the orthopedic provider will likely order an X-ray to measure your child’s spinal curve.
Health care providers measure scoliosis curves in degrees:
- A mild curve is less than 20 degrees.
- A moderate curve is between 25 degrees and 40 degrees.
- A severe curve is more than 50 degrees.
How Is Scoliosis Treated?
Most mild scoliosis curves don't need treatment. Kids with mild curves do need to go for regular checkups to be sure the curve doesn't get bigger. Scoliosis is more likely to get worse as long as the bones are still growing. So doctors keep an eye on kids, sometimes until they're in their late teens.
When doctors think moderate-to-severe curves might get worse or cause problems, they usually want kids to wear a back brace until they finish growing. The brace doesn't make an existing curve go away, but it can stop it from getting worse.
Kids with severe scoliosis might need surgery.
There's no quick fix for scoliosis. Wearing a brace or recovering from surgery takes a while. This can be tough on kids (and parents!). Your care team can put you and your child in touch with other families who have gone through the same thing or help you find support groups.
There are several different types of braces. Because each child's curve is different, the orthopedic specialist will decide on the number of hours a child should wear a brace.
The brace acts as a holding device that keeps the curve from getting worse. A brace won't make the spine straight. But if it does its job well, the curve won't get bigger.
Scoliosis care teams work with kids to choose the right brace. The right brace is the one that works best for the type of curve a child has. It's also the one a child is most likely to wear. Wearing a brace appropriately can prevent the need for surgery.
Some kids with severe scoliosis need a type of surgery called a spinal fusion. During the operation, an orthopedic surgeon straightens the spine as much as possible and holds it in place with rods and screws. The surgeon then puts in a bone graft to join (fuse) some of the vertebrae together. That way, the curve can't get worse.
After about 6 months, the bones should be fully fused. The metal rods are no longer needed, but stay in the back because they aren't doing any harm and taking them out requires another operation.
What Else Should I Know?
Kids with scoliosis can live full and active lives. As long as people with scoliosis get the right treatment as kids, the spine usually won't continue to curve after they're done growing.