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Diseases & Conditions

Pediatric Scoliosis

What is pediatric scoliosis?

Scoliosis is a medical condition in which a person’s spine abnormally curves sideways or rotates. Scoliosis can range from mild to severe. Patients with mild scoliosis may only need to have frequent monitoring from their doctor. Those with more severe cases may need braces or surgery.

Who gets pediatric scoliosis?

About 2% of the population is affected by scoliosis. Scoliosis can affect people of any age, but it is most common in adolescents.

What are the different types of pediatric scoliosis?

There are three different types of pediatric scoliosis:

Idiopathic scoliosis is the most common type of scoliosis. It is "idiopathic," meaning its cause is unknown, but because it runs in families, it has a genetic basis.

Congenital scoliosis is a fairly rare spine abnormality detected at birth.

Neuromuscular scoliosis is a curvature of the spine caused by abnormalities in the muscles and nerves that support the spine. Examples include patients with cerebral palsy, spina bifida, and muscular dystrophy.

What are the symptoms of pediatric scoliosis?

Scoliosis usually causes no pain, so symptoms can often go unnoticed. Parents or caregivers should watch for the following signs:

  • Uneven shoulders
  • Constant leaning to one side
  • Uneven leg length
  • Prominent shoulder blade or shoulder blades
  • An uneven waist
  • Elevated hips

If you notice any of these signs in you child, you should contact your doctor for screening.

How is pediatric scoliosis diagnosed?

If you or a caregiver or teacher thinks your child may have scoliosis, you should contact your doctor as soon as possible. The doctor should also be screening for scoliosis on a regular basis and may be the first to suspect the condition.

An evaluation for scoliosis has several steps. Your doctor will usually begin with a thorough history to determine if there is a family history of scoliosis. The history will also be used to screen for birth defects or trauma that may explain the curvature of the spine.

The doctor will then conduct a physical examination of your child's back, chest, pelvis, legs, feet, and skin. The doctor will be looking to see if his or her shoulders are level, whether the head is centered, and whether opposite sides of the body look level.

He or she will then ask the child to bend forward so that the back muscles can be examined and to see if one side of the rib cage is higher than the other.

While checking the limbs, the doctor will be evaluating whether the limbs are the same length. He or she will also check for abdominal muscle strain, which could cause spinal curvature.

After a physical examination, the doctor may order an X-ray of the spine to confirm a diagnosis of scoliosis. This X-ray will be taken with your child standing so that the entire spine can be seen. The doctor will then measure the curves of the spine as shown on the X-ray. Curves that are greater than 25 degrees may require treatment.

If your doctor determines that your child has scoliosis, he or she will refer you to an orthopaedic spine specialist for treatment.

How is pediatric scoliosis treated?

The type of treatment for pediatric scoliosis depends on several factors:

  • The type of scoliosis
  • The kind and degree of the curve
  • Your family history of scoliosis
  • Your child's age
  • The number of remaining growth years they have until skeletal maturity

The majority of children with scoliosis will have mild cases that only require monitoring every 4 to 6 months.

If your child's doctor notices that the spinal curve is getting worse, he or she may prescribe the use of a custom brace to prevent it from progressing even more.

If the brace does not control the spinal curve, or the curve is severe when the child is first seen, surgery may be necessary. This is usually recommended for patients when the spinal curve is more than 45 degrees. Surgery has been found to be a very effective treatment for severe scoliosis.

Your child's doctor can best evaluate what is the proper course of treatment for him or her.

Can children with scoliosis still exercise and participate in physical activity?

Yes. While it will not cure scoliosis, exercise might lessen any potential reduction in your child’s physical function over time. Keeping physically fit and exercising can also improve your child's overall sense of well-being and happiness.

References:

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). Scoliosis. www.niams.nih.gov. Updated July 2008. Accessed December 2010.

Spiegel DA, Harish SH, Dormans JP. The spine. In: Kliegman RM, Behrman RE, Jenson HB, Stanton FB, editors. Nelson Textbook of Pediatrics. 18 th ed. Philadelphia: WB Saunders; 2008:chap 678.

Scoliosis Research Society. Juvenile Scoliosis. www.srs.org. Accessed December 2010.

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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 3/9/2011…#14521