Scoliosis is a lateral curvature of the spine. It can have a variety of causes. Some patients are born with it (congenital scoliosis). Others develop it secondary to neurologic conditions, skeletal dysplasias, metabolic bone diseases, fractures or degeneration of the spine with age. The most common type of scoliosis is called idiopathic scoliosis. The exact cause of this type of scoliosis is unknown, but there is almost certainly a genetic component of it in most cases. It can occur in the infantile age group (less than 5 years of age), the juvenile age group (age 5-10) or the adolescent age group (older than 10). Adolescent Idiopathic Scoliosis is the most common form of scoliosis that we see.
- Females are more commonly affected by scoliosis. Although males can have scoliosis, progressive scoliosis requiring treatment is 10x more common in adolescent girls than boys.
- There is no way to prevent scoliosis from occurring. Exercise, good nutrition or sports involvement does not seem to prevent a curvature from developing. Physical therapy can be used as an adjunct to brace treatment in patients with scoliosis, but by itself exercise programs do not seem to prevent curve progression.
- There is no correlation between heavy backpack use and spinal curvature. Again, genetics probably plays a major role. Although several studies have documented the relationship between back pain and heavy backpacks, there has never been any causal relationship between scoliosis and carrying a heavy backpack.
- Scoliosis, especially minor curves, does not typically cause back pain. Therefore it can be a relatively silent problem unless looked for by the child’s pediatrician or during a school screening program if present in your child’s school. Most pediatricians are very aware of checking for a spinal curvature in pre-adolescent and adolescent children. Make sure your child’s doctor looks for this at every well child visit!
- Once detected, scoliosis of greater than 20-25 degrees in a growing child can be effectively treated in a brace. Bracing does not make scoliosis go away. But it is effective in preventing curve progression if fitted and worn properly. Surgery is generally indicated in curves greater than 50 degrees. Early detection and appropriate non operative treatment is designed to prevent progression into the surgical range.
To learn more about Adolescent Idiopathic Scoliosis, check out this infographic brought to you by the HSS Lerner Children’s Pavilion
Dr. John S. Blanco is a pediatric orthopedic surgeon at Hospital for Special Surgery’s Lerner Children’s Pavilion. He specializes in scoliosis correction (anterior and posterior), clubfoot correction, pediatric fracture management, and management of neuromuscular conditions. Throughout his career, Dr. Blanco has published numerous articles on a variety of topic including scoliosis, pediatric fracture management, slipped capitol femoral epiphysis and cerebral palsy.