Back Pain Information for Kids

Scoliosis: What is it?

Scoliosis (skoe-lee-oo-sis) is a condition that causes the spine to curve to the left or right side. Sometimes the curve resembles the letter S or C. Scoliosis can develop during childhood or adolescence. The changes scoliosis causes can happen slowly over time or more quickly as the child goes through a growth spurt.

Natural Curves in the Spine
During growth, the spine develops natural curves at the cervical (neck), thoracic (chest), and lumbar (low back) regions. These normal curves work as part of the spine's shock absorbing system to spread out the stress created by body movements. These curves can be seen on an x-ray taken from the side of the body.

side view of spine, curves
Curves Caused by Scoliosis
Scoliosis causes the spine to curve in the wrong direction. A normal spine, when viewed from behind, is straight from the neck to the buttocks. In a back affected by scoliosis, the spine is not straight up and down. The spine may curve to the left or to the right. The curves are measured in degrees. In many cases, the curves are minor.

scoliosis

Another aspect of scoliosis is rotation. The disease can cause the bones in the spine (vertebrae) to turn. In the chest area (thoracic spine), rotation can force the rib cage to turn out of position.

Not Many Children Get Scoliosis
In the United States, 3 to 5 children out of 1,000 will develop the type of scoliosis that needs treatment. Worldwide, scoliosis affects 1% of the population. Scoliosis can affect babies, toddlers, children, and adolescents. Scoliosis occurs more commonly in girls. Sometimes the doctor does not know why a child develops scoliosis. This type of scoliosis is called Idiopathic Scoliosis. Idiopathic (id-dee-oh-path-ick) simply means unknown.

A key to treating scoliosis is to find it early. Many schools check their students - both boys and girls! - for scoliosis. This is simple. Each student bends over at the waist as though diving into a swimming pool. The school nurse looks at the back and can tell if something isn't just right. This is nothing to fear.

Visiting an Orthopaedic Doctor
An Orthopaedic Doctor specializes in bones and muscles. These body parts are called the musculoskeletal system. "Musculo" means muscle and "Skeletal" means bone. The doctor will review the medical and family history and ask if anyone in the family had scoliosis.

The doctor will also examine the patient's spine, posture, and look to see if the hips, shoulders, rib cage, and waist are even. Scoliosis can cause one side of the body to look higher than the other side. The doctor will also check the spine's flexibility. For example, how far can the patient bend forward, backward, to the side, and twist at the waist. The doctor even measures the length of each leg. If one leg is shorter than the other, this could explain why one hip looks higher than the other.

The doctor also checks to make sure the nerves are working properly. This is called a Neurological Examination (ner-row-logic-all). The spine has many nerves that shoot off the spinal cord like branches from a tree. These nerves pass through the spinal bones on their way to other parts of the body. If the scoliotic curve presses on a nerve it might cause numbness or pain. This is not very common. The doctor will help a patient who is in pain or any discomfort.

X-rays of the spine are next. From the x-ray, the doctor can measure the curve in degrees. He can even tell how old the bones are! Maturity is an important key to treating scoliosis. When your spine is growing, it is more flexible. Usually by the age of 16 to 18, your spinal growth is complete and curves under 40 degrees will probably not progress any farther. Occasionally, even when growth is complete, smaller curvatures may progress and later follow-up may be advisable.

Updated on: 02/01/10
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Scoliosis: How is it Treated?

The standard treatment for scoliosis is bracing. A brace can help prevent the curve from getting worse. Fortunately, not every scoliosis requires treatment!
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