Questions and Answers about Scoliosis in Children - Treatment Options for Scoliosis

Scoliosis is a condition in which the spine—in addition to the normal front to back curvature—has an abnormal side-to-side “S-” or “C”-shaped curvature. The spine is also rotated or twisted, pulling the ribs along with it to form a multidimensional curve.

Three to five children out of every 1,000 develop spinal curves that are considered large enough to require treatment. Idiopathic scoliosis does tend to run in families, although no one genetic link has been confirmed.

Scoliosis occurs, and is treated, as three main types:

• idiopathic scoliosis: the most common form, with no definite cause, mainly affecting adolescent girls, but existing in three age groups:
• adolescent idiopathic scoliosis
• juvenile idiopathic scoliosis
• infantile (early-onset) idiopathic scoliosis
   
• neuromuscular scoliosis: associated with a neuromuscular condition such as cerebral palsy, myopathy or spina bifida
   
• congenital scoliosis: present at birth, caused by a failure of the vertebrae to form normally—the least common form

In general, curves measuring 25 to 50 degrees are considered large enough to require treatment. Curves greater than 50 degrees will likely need surgery to restore normal posture.

What will make the spine go back to being straight again?

A scoliosis curve will not get straight on its own. Bracing will help it from getting worse. Surgery — a spinal fusion — is the only thing that will straighten out the spine, but it will not make it completely straight.

What happens if my child has just a slight curve?

Children who have mild curves (less than 20 degrees) or who are already full grown, will be monitored to make sure the curve is not getting worse. Your doctor will check your child's spine every 6 months and schedule follow-up x-rays about once a year.

Will having so many x-rays cause future health problems?

X-rays are necessary to follow the progression of the curve. There can be small negative effects with frequent x-rays, but these effects are minimized by using protective shields over certain body parts to protect the child from unnecessary exposure.

What happens if no treatment is done? Will the curve get worse?

Two factors can strongly predict whether a scoliosis curve will get worse: young age and a larger curve at the time of diagnosis. Children younger than 10 years with curves greater than about 35 degrees tend to get worse without treatment.

Once someone is done growing, it is very rare for a curve to progress rapidly. We know from studies that once someone is fully grown, scoliosis less than 30 degrees tends not to get worse, while those curves greater than 50 degrees can get worse over time, by about 1 to 1 1/2 degrees per year.

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