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What is Scoliosis?

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 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 straighten severe cases of scoliosis.





Signs and symptoms of scoliosis may include:

    • Uneven shoulders
    • One shoulder blade that appears more prominent than the other
    • Uneven waist
    • One hip higher than the other


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 seek medical advice
Go to your doctor if you notice signs or symptoms of scoliosis in your child. Mild curves can develop without the parent or child knowing it because they appear gradually and usually don't cause pain.





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. Experimental testing is being done to determine if blood tests can determine the risk that scoliosis will get worse in a given individual. This type of testing is likely to be more common in the future.


Less common types of scoliosis may be caused by:

    • Neuromuscular conditions, such as cerebral palsy or muscular dystrophy
    • Birth defects affecting the development of the spine
    • Wear-and-tear arthritis in the spine
    • Having one leg longer than the other



Risk factors


Risk factors for developing the most common type of scoliosis include:

    • Age. Signs and symptoms typically begin during the growth spurt that occurs just prior to puberty.
    • Sex. Although both boys and girls develop mild scoliosis at about the same rate, girls have a much higher risk of the curve worsening and requiring treatment.
    • Family history. Scoliosis tends to run in families.






While most people with scoliosis have a mild form of the disorder, scoliosis may sometimes cause complications, including:

    • Lung and heart damage. In severe scoliosis, the rib cage may press against the lungs and heart, making it more difficult to breathe and harder for the heart to pump. In very severe scoliosis, damage to the lungs and the heart can occur. Anytime breathing is compromised, the risk of lung infections and pneumonia increases.
    • Back problems. Adults who had scoliosis as children are more likely to have chronic back pain than are people in the general population. Also, people with untreated scoliosis may develop arthritis of the spine.




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 your child has a positive screen for scoliosis at school, see your doctor to confirm the condition.

What you can do


Before the appointment, write a list that includes:

    • Detailed descriptions of your child's signs and symptoms, if any are present
    • Information about medical problems your child has had in the past
    • Information about the medical problems that tend to run in your family
    • Questions you want to ask the doctor

What to expect from your doctor

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:

    • Muscle weakness
    • Numbness
    • Abnormal reflexes




Tests and diagnosis


Plain X-rays can confirm the diagnosis of scoliosis and reveal the severity of the spinal curvature. If a doctor suspects that an underlying condition — such as a tumor — is causing the scoliosis, he or she may recommend additional imaging tests, including:

    • Magnetic resonance imaging (MRI). MRI uses radio waves and a strong magnetic field to produce very detailed images of bones and soft tissues.
    • Computerized tomography (CT). CT scans combine X-rays taken from many different directions to produce more-detailed images than do plain X-rays.
    • Bone scan. Bone scans involve the injection of a radioactive material, which travels to the parts of your bones that are injured or healing.








*Information taken from: http://www.mayoclinic.com/health/scoliosis/DS00194*