Scoliosis in Children: A Complex Disorder

What Is Scoliosis?

The spine's normal curves occur at the cervical, thoracic, and lumbar regions. These natural curves position the head over the pelvis and work as shock absorbers to distribute mechanical stress during movement.

To understand this concept consider that in some cases, as the spine curves abnormally, the involved vertebrae are forced to rotate. If rotation occurs at the thoracic level of the spine, vertebral turning impacts the rib cage and may result in rib prominence on the opposite side of the curve. In severe cases, lung and heart function can be compromised. Fortunately, severe cases of scoliosis (above example) are not as prevalent as smaller curves.

In the United States, 3 to 5 children out of 1,000 will develop scoliotic curves large enough to warrant treatment. In fact, the worldwide prevalence of scoliosis, including all forms of the disease, is only 1%.

Types of Scoliosis

Infantile scoliosis occurs before age three and is seen more frequently in boys. Although neurologic involvement is possible, many resolve spontaneously. Some may progress to severe deformity.

Juvenile scoliosis is found more frequently in girls between the ages of 3 and 10. These curves are at a high risk for progression and often require surgical intervention.

Adolescent scoliosis, also termed Adolescent Idiopathic Scoliosis (AIS) occurs between age 10 and maturity. AIS may start at the onset of puberty or becomes apparent during an adolescent growth spurt. Females are at higher risk, often requiring surgical treatment, if non-operative treatment fails to halt curvature.

Scoliosis can be congenital, meaning it was caused by a vertebral defect discovered at birth. Idiopathic scoliosis simply means the scoliosis occurred without known cause.