Idiopathic Scoliosis

What is idiopathic scoliosis?

Idiopathic scoliosis is a sideways spine curvature with an unknown cause. Your spine may look like the letters C or S. This is the most common type of scoliosis. Children most often receive this diagnosis after a growth spurt in adolescence.

Scoliosis isn’t usually painful — your child might not even notice they have it. It won’t prevent them from playing, participating in sports or doing other childhood activities. So, you’ll probably be surprised if you receive a note that mentions your child should see their pediatrician about scoliosis after an in-school screening.

The size of the curve can vary from person to person. Mild cases may not need treatment, but severe ones might require surgery.

How common is idiopathic scoliosis?

Idiopathic scoliosis is the most common childhood spinal abnormality. It affects an estimated 2% to 3% of adolescents in the United States.

What are the signs of idiopathic scoliosis?

The signs of idiopathic scoliosis include:

• Uneven shoulders, hips or waist.
• One leg that looks longer than the other.
• Ribs that stick out on one side of your child’s torso.

These signs might not be noticeable until your child has a growth spurt, usually during puberty.

What are the symptoms of idiopathic scoliosis?

While rare, symptoms may happen with severe idiopathic scoliosis curves. These include:

• Back pain or discomfort.
• Numbness (arms and legs).
• Muscle weakness.

What’s a severe idiopathic scoliosis curve?

A healthcare provider will measure the curve in your child’s spine to determine its severity with a scoliometer measuring tool. A curve above 40 degrees is severe and may need surgery. Curves over 25 degrees usually require treatment with a brace.

What causes idiopathic scoliosis?

The word “idiopathic” means that healthcare providers don’t know the cause of a condition. Research suggests idiopathic scoliosis may result from genetics or environmental factors.

What are the risk factors for idiopathic scoliosis?

You’re more likely to develop idiopathic scoliosis if a biological parent or sibling has the condition.

What are the complications of idiopathic scoliosis?

Complications of idiopathic scoliosis happen with severe, untreated curves. These may include:

• Severe back pain.
• Nerve damage.
• Lumbar radiculopathy.
• Shortness of breath (respiratory problems).
• Heart problems (like mitral valve prolapse).

Idiopathic scoliosis may affect your child’s self-esteem. They might feel like they look different than other kids their age. Your child may benefit from talking to a mental health professional about how this condition affects how they feel emotionally.

How is idiopathic scoliosis diagnosed?

A scoliosis diagnosis happens after a scoliosis screening. This is an exam that a primary care physician or a school nurse performs. Your child’s provider will look at their back (with their shirt removed) to check their posture, alignment and possible spine curves. During the exam, a provider may ask your child to stand up straight and bend forward.

If a provider suspects scoliosis, your child may need imaging tests (like an X-ray) so their provider can learn more about the bones in your child’s spine.

When is idiopathic scoliosis diagnosed?

A scoliosis screening and diagnosis usually happens during a pediatric wellness visit between ages 10 and 15 (adolescence).

Can adults be diagnosed with idiopathic scoliosis?

Yes. Scoliosis can progress (get worse) as you age. Sometimes, people with mild scoliosis cases don’t receive an official diagnosis during childhood. As the condition progresses, you may notice signs or symptoms as an adult. A healthcare provider may perform a scoliosis screening and imaging tests to diagnose it.

How is idiopathic scoliosis treated?

Treatment for idiopathic scoliosis varies based on the severity of the curve in your child’s spine. Common treatments include:

• Monitoring the curve during regular checkups with a physician.
• Wearing a brace.
• Undergoing surgery.

Idiopathic scoliosis brace

Your child may need to wear a brace to prevent the curve from getting worse as they grow. A brace won’t straighten the curve, but it may reduce their need for surgery.

There are several types of braces for scoliosis. A provider will choose one that best fits your child and their activity level. They’ll also let you know how long your child needs to wear a brace. For example, your child may be able to take the brace off to shower, play sports and sleep.

A brace can easily hide underneath your child’s clothing but may show if they wear tight-fitting clothing.

Idiopathic scoliosis surgery

People with severe cases of idiopathic scoliosis may require surgery. This helps stabilize their spines and reduce the severity of the curve. Surgery can also prevent complications, like respiratory problems, that are common with severe spinal curves.

Before planning treatment, your child’s provider will consider the following factors to make sure surgery is a safe option:

• Curve location.
• Curve severity.
• Your child’s age.
• If your child is fully grown.
• Curve progression.

The type of surgery most common for idiopathic scoliosis is spinal fusion. A surgeon will straighten or realign the curve to improve your child’s posture. Then, they’ll fuse (connect) spinal bones (vertebrae) together. When fused bones heal, they’ll become one solid bone.

When a surgeon fuses bones together, it stops growth in that area of the spine. Depending on your child’s age, they may still be growing. Therefore, a spinal fusion can affect their overall height. Your child’s provider will consider this factor when they’re planning surgery.

If your child has a severe curve and is still growing, they may be a candidate for a growth-modulating surgery. These procedures harness your child’s remaining growth, allowing them to “grow straighter” and, at the same time, avoid fusing the bones together. This keeps the spine mobile. An X-ray of your child’s hand is the most accurate way to determine how much growth is remaining.

Can idiopathic scoliosis be prevented?

You can’t prevent idiopathic scoliosis since the cause is unknown. A healthcare provider may suggest wearing a brace to prevent the curve from getting worse.

What can I expect if my child has idiopathic scoliosis?

Idiopathic scoliosis is progressive. This means that the curve in your child’s spine may get worse as they get older. For example, a curve that measures between 30 to 50 degrees may increase 10 to 15 degrees over a person’s lifetime. Curves over 50 degrees may increase by 1 degree per year.

A healthcare provider will monitor and measure the size of the curve during regular checkups. They’ll let you know if treatment, like wearing a brace or undergoing surgery, is necessary. Many children don’t need surgery right away, but if symptoms or complications arise, this could change.

Scoliosis can affect the way your child looks compared to their peers. This may affect their self-esteem. For example, your child might avoid certain activities like swimming if they have to wear a bathing suit in front of others. Talk to a mental health professional if scoliosis affects your child’s emotional well-being.

Does idiopathic scoliosis go away?

No, idiopathic scoliosis doesn’t go away on its own. A healthcare provider and surgeon can offer treatment options to stabilize the spine, correct the curve or prevent it from getting worse.

Does idiopathic scoliosis get worse with age?

Idiopathic scoliosis is progressive and can get worse as a child gets older. Treatment options can prevent this from happening, so talk with your child’s healthcare provider.

When should I see a healthcare provider?

Visit a healthcare provider if you notice signs or symptoms of scoliosis in your child. A provider will perform a screening and order imaging tests or confirm the results of an in-school screening.

If your child has an idiopathic scoliosis diagnosis, let their provider know if:

• Your child has symptoms like pain or discomfort.
• Symptoms get worse instead of better with treatment.
• Your child experiences shortness of breath or other complications.

What questions should I ask my healthcare provider?

Questions you may want to ask your child’s provider include:

• What type of treatment do you recommend?
• How long does my child need to wear a brace?
• How do I help my child wear a brace if they say it’s uncomfortable?
• Does my child need surgery?
• How do I take care of my child after surgery?
• What activities are safe for my child?

A note from Cleveland Clinic

Idiopathic scoliosis is a common condition that affects adolescents, but it rarely slows kids down. Your child might not notice or remember they have it until they see their provider for a checkup.

Some cases may require your child to wear a brace. This can be a challenge if your child doesn’t want to wear one or tries to take it off when you’re not looking. A healthcare provider may offer suggestions to make wearing a brace a little easier on you and your family.

Severe cases might require surgery. Your child’s care team can answer any question you (or your child) have about the procedure. Recovery may take your child out of their regular activities for a few weeks as their body heals, but they’ll be able to get back into their routine before you know it.