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Scoliosis in Children

Scoliosis is a condition that causes the spine to curve to the left or right side in growing children. Most cases of scoliosis are mild, but some curves worsen as children get older. If left untreated, scoliosis can cause heart and lung problems.

At Banner Children’s, our caring team can help. Learn how scoliosis may affect your child, symptoms to watch for and treatment options.

What is scoliosis?

Scoliosis is a spinal condition where the spine curves or rotates (twists) sideways. It is most often diagnosed in childhood or the teen years.

When looked at from behind, a normal spine looks like a straight line. However, in scoliosis, the vertebrae (the small bones in the spine) form a curved line – often appearing like the letter “C” – instead of a straight line. In addition, the spine can sometimes twist like a corkscrew, forming an “S” shape.

Scoliosis in children can range from mild to severe based on the spine’s curve. Most cases are mild, but some curves get worse as a child grows. Scoliosis curves are measured in degrees:

  • Mild scoliosis: A mild curve is less than 20 degrees.
  • Moderate scoliosis: A moderate curve is 25 to 45 degrees.
  • Severe scoliosis: A severe curve is more than 50 degrees.

What causes scoliosis?

Scoliosis affects between six to nine million people in the United States. There are many types of scoliosis. Some children are born with it, while others develop it during growth spurts.

Even though scoliosis tends to run in families, in more than 80% of scoliosis cases the cause is unknown. This is known as idiopathic scoliosis or early-onset scoliosis. Within this category, idiopathic scoliosis is broken down by age:

  • Infantile idiopathic scoliosis: Newborn to 3 years. Although this type is rare, infantile idiopathic scoliosis is often connected with other medical conditions. It requires close monitoring and early treatment.
  • Juvenile idiopathic scoliosis: Ages 4 to 10 years. It is more common than infantile idiopathic scoliosis but happens less than adolescent idiopathic scoliosis. Regular monitoring and treatment are very important to stop the spine curve as the child grows.
  • Adolescent idiopathic scoliosis: Ages 10 to 18 years. This is the most common form of idiopathic scoliosis. It typically develops during the teenage growth spurt. It affects both genders, but girls are more likely to have larger curves. Regular monitoring and treatment may be needed, depending on how the curve grows.
  • Adult idiopathic scoliosis: 18 years and older. Some adults are diagnosed after their teen years. The good news is that treatment can still help.

A small number of cases are caused by other medical conditions, including:

  • Congenital scoliosis. This type of scoliosis happens when something goes wrong with how the spine develops before a baby is born.
  • Neuromuscular scoliosis. This is caused by brain, spinal cord and muscular system disorders like cerebral palsy, spina bifida or muscular dystrophy.
  • Syndromic scoliosis. This type of scoliosis happens because of an underlying medical problem like Marfan syndrome or Ehlers-Danlos syndrome.

Most cases of scoliosis are not preventable. However, understanding your child’s risk factors and regular screenings can help your child get treatment as early as possible, if needed.

What are the symptoms of scoliosis?

Usually, scoliosis is not painful so you may not see any symptoms. Also, the signs of scoliosis can be different from child to child.

Some scoliosis symptoms to look for in your child include:

  • Uneven shoulders: One shoulder seems higher than the other.
  • Uneven shoulder blade height or position: One shoulder blade sticks out more than the other.
  • Uneven hip height or position: One or both hips are raised or unusually high.
  • A difference in the way the arms hang beside the body when your child stands straight
  • A visible curve in the spine.
  • Uneven rib cage: One side of the rib cage is higher than the other.
  • One side of the back is higher than the other when your child bends over and touches their toes.

How is scoliosis diagnosed?

Early diagnosis can help stop the growing curve and improve how well treatment works. Because of this, health care providers and some schools regularly check children and pre-teens for signs of scoliosis.

If you think your child might have scoliosis, contact their health care provider to schedule a test. 

Tests for scoliosis

The usual first test for scoliosis is called the Adam’s Forward Bend test. During the test, your child stands with their feet together and bends forward from the waist, with arms hanging loosely. The health care provider will check your child’s posture, the back's shape and the spine’s curvature.

In addition to the bend test, your child’s provider may perform another test to check your child for areas of numbness, tingling and weakness.

If a provider thinks your child may have scoliosis, they may order a scoliosis X-ray or a full spine X-ray with images of your child’s front and sides. This test is used to see where scoliosis affects the spine and to measure any curves. In some cases, imaging tests such as an MRI or CT scan may also be recommended.

If your child’s provider diagnoses your child with scoliosis, they will be referred to an orthopedic specialist.

How is scoliosis treated?

The goal of treatment is to stop the curve from growing and help your child’s spine align correctly. Treatment will depend on the type of scoliosis, how severe the curve is, if the curve will grow and your child’s age.

The main treatment options include monitoring, spinal bracing and spine surgery.

Non-surgical scoliosis treatments

Monitoring: Most children with scoliosis will have mild cases that only require getting checked every four to six months.

Spinal bracing: If your provider notices that your child’s spinal curve is moderate or getting worse, they may recommend that your child wear a back brace. The brace cannot cure scoliosis or fix the curve, but it usually stops the curve from getting worse. The brace will be custom-made to fit your child’s body and is designed to be difficult to see under loose-fitting clothing.

The brace is usually worn all day and only removed for bathing, swimming and contact sports. Wearing a brace is fine for everyday activities, including most non-contact sports.

The brace is usually worn until your child’s stops growing.

Surgical treatment

Surgery is recommended only in severe cases of scoliosis and when bracing has not stopped the curve from worsening. When possible, the surgeon will delay surgery until after a child’s growth spurt.

The most common type of spinal surgery in older children is spinal fusion. This type of operation uses metal rods, hooks, screws and wires to straighten the spine. Sometimes, a back brace must be worn after surgery to protect the back as it heals.

Younger children under age 10 may have growing rods inserted. These rods help control the growth of the spine while also helping to correct the scoliosis. Many children must also wear a brace to protect the growth rods.

In some cases, the rods can be lengthened using special magnets outside the body during an outpatient visit. When your child stops growing, the adjustable rods can be removed.

The importance of follow-up care

Regular follow-up appointments are very important if your child has scoliosis. These appointments are important to monitor how the curvature of the spine is progressing and to assess the effectiveness of treatment.

During these visits, your child’s health care provider will check your child's growth and sometimes do imaging tests (such as X-rays) to get a clear picture of any spine changes. Your child’s treatment plan can be adjusted based on these tests.

Lifestyle modifications

Like all children, a healthy lifestyle is important. Regular exercise, good nutrition and staying at a healthy weight helps them grow into strong adults.

Activities that strengthen the core (stomach and back) muscles and help with good posture may be useful. However, it’s important to check with your child’s health care provider to decide which activities are safe, based on your child’s condition and treatment plan.

Can my child participate in sports if they have scoliosis?

Playing sports will not make scoliosis worse. Keeping fit and exercising can help with back pain and make your child’s muscles stronger.

However, if your child has had back surgery, they should avoid contact sports like hockey, wrestling and football. Check with your child’s provider before jumping into any new sport.

What is the long-term outlook for children with scoliosis?

Most children and adolescents with scoliosis – especially those diagnosed and treated at younger ages – can look forward to normal, active lives.

Emotional support

Coping with scoliosis can be emotionally difficult for kids, especially during the teen years. Encourage your child to talk with friends and ask for their support. Consider joining support groups for parents and kids to help connect you with others facing similar challenges.

As a parent, It's important to listen to and support your child. Parents can seek age-appropriate education resources from health care providers and support groups, which can help you navigate your child's scoliosis. By providing emotional support and education, parents can help their child feel understood, supported, empowered and loved.

How we care for scoliosis at Banner Children’s

If you have concerns that your child has scoliosis, contact Banner Children’s. Our pediatric orthopedic specialists can offer you and your child complete care to cover all of your scoliosis needs.