If a doctor has diagnosed your child with scoliosis, you may be feeling overwhelmed. Chances are, you’ve heard of scoliosis before. But you likely have a lot of questions.
First, keep in mind that if a school nurse has raised a concern during a routine school screening, that’s not the same as a diagnosis. But it’s still a good idea to have your pediatrician check your child. If a pediatrician suspects scoliosis, they’ll send you to an orthopaedic specialist.
Learn more about the different types of scoliosis in kids — and how doctors treat it.
What Is Scoliosis?
Our spines have several natural curves in our neck, back, and low back. In fact, these curves allow the spine to absorb the stress of standing and sitting. But these are front to back curves.
Scoliosis is a sideways curve of the spine. If a spine curves too much to one side — to the left or to the right — it’s a scoliosis curve.
These scoliosis curves can be small curves or large curves. Small ones often don’t need any treatment. Kids and teens with larger curves may need treatment, including bracing or surgery.
Scoliosis curves aren’t usually painful, but large ones can cause problems with posture. Kids with very large curves can also be self-conscious about their uneven shoulders or hips. Later in life, scoliosis curves can also cause health issues, such as back pain and breathing problems.
That’s why it’s best to talk to your child’s orthopaedic surgeon about scoliosis treatment options during teen years.
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How Common Is Scoliosis in Teens and Kids?
About 2% to 3% of the U.S. population has some degree of scoliosis. The curve of your child’s spine needs to be at least 10 degrees before a doctor will diagnose scoliosis. But usually, doctors only suggest treatment for curves of 25 degrees or more.
Pediatricians or other providers usually notice a scoliosis curve in kids between the ages of 10 and 15. Scoliosis in kids can develop earlier though.
Scoliosis happens evenly among both males and females. However, girls are more likely to have a curve large enough that it requires treatment.
Scoliosis isn’t related to things like carrying a backpack that’s too heavy. It may have a genetic factor though. About 30% of kids with scoliosis have a family history of it.
Types of Scoliosis in Kids
The most common type of pediatric scoliosis is idiopathic scoliosis. This means there is no clear cause and it’s not related to another condition. About 80% of the time, adolescents with scoliosis have idiopathic scoliosis.
Two other types of scoliosis include:
- Congenital scoliosis: This means the spine doesn’t form exactly as it should when a baby is in the womb. Doctors can sometimes diagnose this type earlier, which is why scoliosis in toddlers is often congenital. Sometimes, though, doctors may not notice a congenital curve until the child starts growing.
- Scoliosis related to a medical condition: Neuromuscular conditions, or conditions that affect muscles and nerves, can cause scoliosis. For example, kids who have muscular dystrophy or cerebral palsy may also have scoliosis. This is because these conditions impact the spine and how it grows.
Symptoms and Signs of Scoliosis in Teens and Kids
Children with idiopathic scoliosis may not have any signs of scoliosis until they hit a growth spurt. Scoliosis curves often emerge around the time of puberty.
Signs and symptoms of scoliosis include:
- Uneven waistline.
- Uneven, tilted shoulders (a shoulder blade may stick out).
- One hip is higher than the other.
- Rib cage is more prominent on one side.
- Head doesn’t seem centered.
- Entire body leans to one side.
Back pain usually isn’t a symptom, at least not with idiopathic scoliosis. If a child is in pain, an underlying medical condition is more likely to be causing their scoliosis.
If a child with severe scoliosis doesn’t get any treatment, the curve can lead to problems. A spine that is too curved can make breathing difficult. Untreated scoliosis can also lead to back pain later in life.
Also, a large curve that’s left untreated can continue to grow, even after a child stops growing.
Common Scoliosis Treatments
Your doctor will show you and your child the X-rays of their spine and explain the type of curve and how severe it is.
There are several ways to treat scoliosis. Your doctor will discuss options with you and your child, based on:
- How old your child is.
- Whether your child has stopped growing.
- The degree of curve and where the curve is.
If your child’s curve is less than 25 degrees, your doctor may suggest observation. Your child will see the doctor once or twice a year for follow-up X-rays. If the curve doesn’t progress, your child may not need any further treatment.
Kids who are still growing and have a curve between 25 and 45 degrees may need to wear a brace. The brace can stop the curve from getting larger — and may prevent the need for surgery later. (A brace isn’t helpful for adolescents with large curves who are already finished growing.)
Most doctors recommend surgery for curves greater than 45 degrees. The classic surgery for scoliosis is spinal fusion.
This surgery realigns the spinal bones (vertebrae) that are curving. The surgeon straightens the curve and then places small pieces of bone in between the vertebrae. Metal rods hold the bones in place until they grow together (fuse) with the other bone.
The surgeon only fuses the part of the spine that has the scoliosis curve. The part of the spine where the fused vertebrae can no longer move. But the rest of the spine can still move as normal.
There have been some advances in scoliosis surgery, with newer techniques that don’t require fusion. These surgeries control the growth of the spine by using implants. They better preserve the mobility of the spine.
Supporting Your Child Through Scoliosis Surgery
Though scoliosis surgery can be scary for both kids and parents, children do very well with it. Most kids are up and walking the day after surgery. Hospitals have different protocols, but your child will likely be home within just a few days.
Teens can go back to school and get back to their basic daily activities within four weeks of surgery. Most kids can get back to sports within six to nine months. Your doctor will talk to you about whether contact sports are a good idea, based on your type of surgery.
Both kids and parents may have fears about what’s ahead after a scoliosis diagnosis. But it’s a condition that orthopaedic surgeons have excellent solutions for. Your child will be able to get back to living their life without having to worry about future scoliosis problems.
Learn more about The Spine Center at UPMC Children’s Hospital of Pittsburgh.
From nutrition to illnesses, from athletics to school, children will face many challenges growing up. Parents often will make important health care decisions for them. We hope to help guide both of you in that journey. UPMC Children’s Hospital of Pittsburgh is a national leader in pediatric care, ranking consistently on U.S. News & World Report’s Best Children’s Hospitals Honor Roll. We provide expert treatment for pediatric diseases, along well-child visits, urgent care, and more. With locations across Pennsylvania, Maryland, and West Virginia, you can find world-class care close to home. We also work closely with UPMC Magee-Womens Hospital, a national leader in care for newborns and their mothers. Our goal is to provide the best care for your children, from birth to adulthood and beyond. Visit our website to find a doctor near you.