An idiopathic scoliosis diagnosis can be scary, especially when doctors start talking about back braces and spinal fusion surgery. The good news is that informed parents are far more likely to achieve a positive outcome for their children.
It all starts with understanding what scoliosis in children is — and what it isn’t. It is a complex condition that causes the backbone to curve, sometimes forming a curved line instead of being straight. Although most people think of the curve of the spine itself as the problem, it’s just the symptom of a deeper defect: genetic deficiencies that prevent the brain from detecting and correcting the backbone’s abnormal posture and spinal deformity during growth spurts. This can cause health problems.
Around 3-5% percent of kids develop some degree of adolescent idiopathic scoliosis during their teenage years. The vast majority of the time, it’s mild and only requires a specific exercise treatment—about 10 percent of the time, the curves progress enough to require surgical intervention.
Type of Scoliosis
In eight out of 10 scoliosis patients, the specific cause is unknown etiology. Idiopathic curvatures most commonly develops during adolescence, during periods of rapid growth. While about 80 percent of cases of scoliosis occur between ages 10 and 18.
Congenital scoliosis or infantile scoliosis: ages 0 to 3 (Toddlers)
- May require an MRI or x-ray to determine vertebra deformity and, casting may be recommended.
- Often related to spinal cord tethering in infantile cases.
Juvenile Idiopathic Scoliosis: ages 4 to 9 (Early onset scoliosis)
- Depending on severity on radiographs, physical therapy or VEPTR instrumentation or growing rods may be recommended until skeletal maturity.
Adolescent Idiopathic Scoliosis: ages 10 to 18 (Most common type of scoliosis)
- Mild scoliosis: At this stage (10-25 degrees), the curve is considered mild. Doctors will often recommend observation of small curves to determine how quickly they’re worsening. But the wait-and-see method has its risks. Below 19 degrees, there’s only a 22 percent chance the curves will continue to progress, but once the spinal curve reaches 20 degrees, the likelihood of progression jumps to 68 percent. Early intervention such as ScoliSMART’s Small Curve Camp can stop scoliosis before it reaches this threshold while reducing existing curvature. Because early detection has such a big impact on treatment outcomes, it’s wise to have your child screened if you suspect a problem. If you recently received a diagnosis, it’s never too early to start looking into non-surgical treatment options.
- Moderate curves: (25-50 degrees) If the child’s spine is still growing when the curve reaches 25 degrees, many doctors will recommend bracing to slow or prevent further progression — unfortunately there is growing evidence that bracing isn’t effective. Alternative therapies have had much greater success at halting spinal curves. For example, the ScoliSMART Activity Suit combines active resistance exercises with other treatments to achieve a 90 percent success rate at stabilizing or reducing spinal curves. It’s important to start using such treatments as early as possible because once the curvature reaches 30 degrees, the odds of progression increase dramatically.
- Severe cases are often recommend for fusion surgery
- 50+ degrees: At 50 degrees, most spinal surgeons will recommend spinal fusion surgery in an attempt to reduce the curve and prevent further progression. However, this high-risk surgery can have devastating side effects and rarely leads to a positive outcome. Fortunately, there are many non-surgical treatment options that can help support and strengthen the spine without fusing its bones together. It’s important to research all of the options so you can make an informed decision for your child.
Now it’s even easier to connect with ScoliSMART. Schedule your no-cost, no-obligation phone or Zoom consultation online with a ScoliSMART physician. Visit the ScoliSMART BootCamp page and click the “Schedule Online” button at the top of the page. Then select the best date and time to connect with a physician. Schedule your consultation right here!
With functional curves, the spine itself is normal but is pulled into a curve by the surrounding muscles. This usually occurs because of a defect or imbalance in the patient’s posture. For example, children with one leg longer than the other or adults who engage in repetitive asymmetrical activities (such as tennis or golf) can develop this condition.
Adult or Degenerative
While it’s more common to diagnose the condition in kids than in adults, this particular type arises after the age of 40. It’s the result of weakening in the spine and vertebra due to age-related conditions seen on radiographs such as arthritis, bone spurs, osteoporosis, and disc degeneration.
What are the causes of scoliosis in children?
The causes in children can vary, but some common factors include congenital spine abnormalities, neuromuscular conditions like cerebral palsy or muscular dystrophy, and idiopathic scoliosis, which has no known cause. Other potential causes include spinal infections, tumors, or injuries.
Risk Factors for Scoliosis: Identification & early signs
Although most of the time we don’t know exactly what causes scoliosis, scientists have identified several risk factors that increase the odds of developing it. For example, we know that it affects seven girls for every one boy. Most early cases occur in girls between the ages of 8 and 14 who have not begun menstruating and have thin, lanky bodies.
Genetics could be the cause of the condition. Around 30 percent of scoliosis patients have a family history of the condition, and while there are many factors involved in the developing a spine curve. This means kids who have siblings, parents, or grandparents with the condition should get screened.
Signs and Symptoms of Scoliosis
Multiple visual indicators could suggest a problem, such as an uneven waistline or uneven shoulders. Uneven posture is probably the most obvious, but there are plenty of other visual signs a child may have a curvature, such as one hip being more pronounced, one shoulder blade sticking out more, one leg appearing shorter than the other, or the body leaning to one side. It is important for parents to be aware of these signs and symptoms and ensure that their child sees a healthcare provider.
Alert parents can sometimes spot the early signs of a curvature during a physical exam depending on the severity of the curve like:
- Uneven hemline, pant legs, or shirt sleeves
- Abnormal postures, such as tilted shoulders, rib cage, or hips
- Unexplained back pain
- The body that leans to one side
- Ribs that stick out during a full forward bend
Many schools and pediatricians screen for spine curves in children at the fifth- or sixth-grade level to catch more cases before they become severe. The SRS, American Academy of Pediatrics, and American Academy of Orthopaedic Surgeons recommend that girls get screened twice at ages 10, and 12 and boys get screened once at age 13 or 14. Treatment ranges from Small Curve Camp, to wearing a back brace, or even corrective surgery in severe cases. Additionally, some school programs regularly check children and pre-teens for initial signs to ensure early diagnosis and successful treatment.
Diagnosis and Treatment of Scoliosis
There are often few noticeable symptoms in the early stages of a spinal curvature. This can make it challenging to identify, but it also reflects that scoliosis need not be detrimental to your child’s health and well-being. If it is diagnosed correctly at a young age and treated adequately throughout a lifetime, your child should see no meaningful changes to their lifestyles and habits. They will still be able to perform the sports and activities they enjoy. In young children, mild curves of the spine have the potential to become worse as the child grows and develops, which is why ScoliSMART doctors always recommend the Small Curve Camp program for early stage intervention. The sooner treatment begins, the sooner your child can get back to their life.