Scoliosis is a common spinal deformity that is often first detected in children and adolescents. With approximately 3 million new cases diagnosed each year, there are multiple types of scoliosis with varying levels of severity — some requiring surgery.
“Scoliosis occurs when the spine curves sideways, in a C or S-shape, rather than being a straight line down the middle of the back,” said Jonathan Camp, MD, pediatric and orthopedic surgeon at Children’s Bone & Spine Surgery and Sunrise Children’s Hospital.
While most cases of scoliosis won’t cause long-term problems, the sooner children are diagnosed with the condition, the sooner they can receive corrective therapy.
Types of scoliosis
All types of scoliosis are defined as a sideways curvature of the spine measuring 10 degrees or larger, but they’re qualified differently depending on the cause.
This is the most common type, accounting for approximately 80 percent of all cases, and has no identifiable cause. It tends to develop during childhood and often is diagnosed during a growth spurt between the ages of 10 and 15. Although doctors don’t know what causes adolescent idiopathic scoliosis, it is considered a partially genetic condition. The Scoliosis Research Society reports that about 1 in 3 children whose parents have scoliosis will develop the condition.
This type occurs because of a spinal malformation in the womb. Rather than develop overtime, children with congenital scoliosis are born with the condition, which also can be “associated with other health issues, as well as heart and kidney problems,” Camp said.
This type is caused by any medical condition that affects the nerves and muscles, such as cerebral palsy, muscular dystrophy and spinal cord injuries.
The only identified risk factor for idiopathic scoliosis is a family history of the condition, though it can occur in children who don’t have a hereditary link to it as well. Further, “it’s a common misconception that carrying a heavy backpack, lack of calcium, playing sports or having poor posture causes scoliosis — it doesn’t,” Camp said.
Because of this, there is no way to prevent idiopathic scoliosis, but early detection and intervention can slow the degree of curvature. It’s important to catch scoliosis while children are developing and before they reach skeletal maturity, giving physicians time to correct the condition using nonsurgical methods.
Symptoms and detection
Depending on the degree of the curve, scoliosis may be subtle or apparent, but it can almost always be detected visually without requiring an X-ray, unless an abnormality is present.
“It’s recommended that adolescents be screened by a physician or nurse multiple times between the ages of 10 and 15,” Camp said.
Most schools schedule routine scoliosis screenings using a process called the Adam’s Forward Bend Test, which is useful in detecting upper- and mid-spine scoliosis — the most common curvature location in cases of adolescent idiopathic scoliosis.
The Adam’s Forward Bend Test requires the child to stand straight, then bend at the waist with arms stretched down and knees straight — similar to a diving position. Often, if scoliosis is present, one side of the rib cage will appear higher than the other side.
Other signs of spinal asymmetry include:
- One shoulder or shoulder blade appearing higher than the other
- One hip bone appearing higher or more prominent than the other
- Uneven curve at the waist
- Body appearing to lean or tilt to one side or the other
- One leg appearing longer or shorter than the other
- Head may not appear centered over the pelvis