Scoliosis

Overview

Mayo Clinic's pediatric orthopedic specialists are experts at diagnosing and treating scoliosis. They work closely with orthotists – specialists who fit, adjust and supervise the use of braces.

Most children with scoliosis have mild spinal curvature (less than 20 degrees) and don't need a brace or surgery. However, they need checkups every four to six months to ensure that curves in the spine do not progress. Mayo treats spinal curves of 25 to 40 degrees with bracing technology; when patients are compliant with wearing a brace, acceleration of scoliosis is prevented in nearly all cases. For spinal curves greater than 40 to 50 degrees, surgery is necessary, and is successful approximately 95 percent of the time.

Mayo's strengths in treating scoliosis include highly trained surgeons and orthotists, an emphasis on patient education from its medical team and a commitment to early identification of the condition.

Children who come to Mayo Clinic in Rochester for surgery are treated at Mayo Eugenio Litta Children's Hospital, a state-of-the-art, family-friendly children's hospital within Saint Marys Hospital. Mayo's professionals, from pediatric anesthesiologists to pediatric cardiologists and pulmonologists, are trained to prevent and treat complications. The hospital also features a pediatric intensive care unit suited to the unique needs of children.

Diagnosis

At Mayo Clinic, children and adolescents who may have scoliosis undergo a physical exam. Mayo specialists look for physical abnormalities, such as an uneven shoulder, prominence of the ribs or one hip higher than the other. X-rays are used to confirm a diagnosis and measure the patient's spinal curvature. Read more about scoliosis diagnosis.

Treatment Options

Most scoliosis patients don't need braces or surgery. However, they should be monitored regularly, especially during the years of rapid growth. Scoliosis patients with severe curves that continue to increase while they are still growing are treated with bracing technology or surgery. Read more about scoliosis treatment options.

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About Scoliosis

Scoliosis is an abnormal curvature and rotation of the spine. From the side, a normal spine takes the form of an elongated S, the upper back bowing outward and the lower back curving slightly inward. Viewed from behind, however, a normal spine should appear as a straight line from the base of the neck to the tailbone. If a child has scoliosis, the view from behind may reveal one or more abnormal curves.

Congenital scoliosis is a birth defect that affects vertebrae development, and often occurs with other congenital problems. This kind of scoliosis may progress rapidly. Other classifications of scoliosis include:

Infantile idiopathic: This is more common in boys and accounts for approximately 5 percent of scoliosis cases. Children who develop scoliosis at a young age are more likely to have curves that worsen.

Juvenile (3 to 10 years): This is more common in girls and accounts for approximately 10 percent of scoliosis cases. Curves in girls are more likely to worsen than are those in boys.

Adolescent (10 years and older): This occurs in both girls and boys and accounts for the majority of scoliosis cases. Scoliosis in adolescent girls is much more likely to get worse than is the case for boys. Monitoring scoliosis at this age is extremely important, because the size of spinal curves may increase during growth spurts.

Adult scoliosis: This type of scoliosis is rare. In most adult cases, the condition was not diagnosed or treated during childhood. Adult scoliosis could stem from a degenerative joint condition in the spine.

While scoliosis runs in families, the cause of most scoliosis is unknown (idiopathic). Sometimes an underlying disease that affects the neuromuscular system, a leg-length discrepancy or a birth defect may cause scoliosis. However, it is not caused by poor posture, diet, or the use of backpacks. Scoliosis does not usually cause pain or other problems, making it hard to notice. It is important to screen children for scoliosis by the time they are 8 or 9 years old.

Most cases of scoliosis don't get worse, and periodic checkups may be all a child needs. Children with a severe curve that continues to increase, however, may require a brace or surgery. Of every 1,000 children, three to five develop spinal curves that are severe enough to require treatment.

In patients whose spinal curves don't get worse, complications from scoliosis are almost nonexistent. Such (very rare) complications include lung and heart damage for severe scoliosis, and back problems for adults who had scoliosis as children. Adults with untreated scoliosis may also develop arthritis of the spine.

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