Scoliosis is a sideways curvature of the spine that occurs most often during the growth spurt just before puberty. While scoliosis can be caused by conditions such as cerebral palsy and muscular dystrophy, the cause of most scoliosis is unknown.
Most cases of scoliosis are mild, but some children develop spine deformities that continue to get more severe as they grow. Severe scoliosis can be disabling. An especially severe spinal curve can reduce the amount of space within the chest, making it difficult for the lungs to function properly.
Children who have mild scoliosis are monitored closely, usually with X-rays, to see if the curve is getting worse. In many cases, no treatment is necessary. Some children will need to wear a brace to stop the curve from worsening. Others may need surgery to keep the scoliosis from worsening and to straighten severe cases of scoliosis.
Viewed from the side, the normal spine takes the form of an elongated S, the upper back bowing outward and the lower back curving slightly inward. Viewed from behind though, the spine should appear ...
Signs and symptoms of scoliosis may include:
If a scoliosis curve gets worse, the spine will also rotate or twist, in addition to curving side to side. This causes the ribs on one side of the body to stick out farther than on the other side. Severe scoliosis can cause back pain and difficulty breathing.
When to see a doctor
Doctors don't know what causes the most common type of scoliosis — although it appears to involve hereditary factors, because the disorder tends to run in families. Less common types of scoliosis may be caused by:
Risk factors for developing the most common type of scoliosis include:
While most people with scoliosis have a mild form of the disorder, scoliosis may sometimes cause complications, including:
Preparing for your appointment
Your child's doctor may check for scoliosis at routine well-child visits. Many schools also have screening programs for scoliosis. Physical examinations prior to sports participation often detect scoliosis. If you are informed that your child might have scoliosis, see your doctor to confirm the condition.
What you can do
What to expect from your doctor
Tests and diagnosis
The doctor will initially take a detailed medical history and may ask questions about recent growth. During the physical exam, your doctor may have your child stand and then bend forward from the waist, with arms hanging loosely, to see if one side of the rib cage is more prominent than the other.
Your doctor may also perform a neurological exam to check for:
Treatments and drugs
Most children with scoliosis have mild curves and probably won't need treatment with a brace or surgery. Children who have mild scoliosis may need checkups every four to six months to see if there have been changes in the curvature of their spines.
While there are guidelines for mild, moderate and severe curves, the decision to begin treatment is always made on an individual basis. Factors to be considered include:
Most braces are worn day and night. A brace's effectiveness increases with the number of hours a day it's worn. Children who wear braces can usually participate in most activities and have few restrictions. If necessary, kids can take off the brace to participate in sports or other physical activities.
Braces are discontinued after the bones stop growing. This typically occurs:
Braces are of two main types:
In spinal fusion, surgeons connect two or more of the bones in the spine (vertebrae) together, so they can't move independently. Pieces of bone or a bone-like material are placed between the vertebrae. Metal rods, hooks, screws or wires typically hold that part of the spine straight and still while the old and new bone material fuses together.
Surgery is usually postponed until after a child's bones have stopped growing. If the scoliosis is progressing rapidly at a young age, surgeons can install a rod that can adjust in length as the child grows. This growing rod is attached to the top and bottom sections of the spinal curvature, and is usually lengthened every six months.
Complications of spinal surgery may include bleeding, infection, pain or nerve damage. Rarely, the bone fails to heal and another surgery may be needed.
This low-profile brace is made of plastic materials and is contoured to conform to the body. ...
These X-ray images show the type of correction that can be achieved with scoliosis surgery. ...
Lifestyle and home remedies
Although physical therapy exercises can't stop scoliosis, general exercise or participating in sports may have the benefit of improving overall health and well-being.
Studies indicate that the following treatments for scoliosis are ineffective:
Coping and support
Coping with scoliosis is difficult for a young person in an already complicated stage of life. Teens are bombarded with physical changes and emotional and social challenges. With the added diagnosis of scoliosis, anger, insecurity and fear may occur.
A strong supportive peer group can have a significant impact on a child's or teen's acceptance of scoliosis, bracing or surgical treatment. Encourage your child to talk to his or her friends and ask for their support.
Consider joining a support group for parents and kids with scoliosis. Support group members can provide advice, relay real-life experiences and help you connect with others facing similar challenges.
Last Updated: 2012-02-03
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