Scoliosis - Office Visit

This is an abnormal, sideways curvature of the spine.




This is an abnormal, sideways curvature of the spine.



Mild to moderate scoliosis is a painless, sideways curvature of the spine. This can cause the hips and the length of the arms and legs to be uneven. The chest or lower spine may also be uneven when the child bends forward.

  • Scoliosis typically develops during middle to late childhood, when growth is accelerated. At this age, scoliosis typically develops spontaneously without a known cause. This is called idiopathic scoliosis.
  • Usually the upper spine is affected. However, the lower spine can also be involved. The neck area is usually not affected.
  • Progression of the condition depends on a number of factors, including the child's age and size of the curve.
  • A small curvature can occur if one leg is longer than the other is. Persistent muscle spasms in the back can also cause a small, temporary curvature.

Although scoliosis can occur at any age, most cases become visible during middle to late childhood. This is when children enter puberty and growth rate is faster. Parents should watch for these traits in children from about age eight.

The following conditions may play a role in the development of scoliosis:

  • Conditions that weaken the muscles that support the spine (cerebral palsy, poliomyelitis and muscular dystrophy)
  • Birth defects of the spinal column
  • Injuries, infections or tumors in the spine
  • Rheumatic diseases, which cause inflammation, swelling and pain in the joints or muscles (i.e., osteoarthritis, rheumatoid arthritis and lupus)
  • Connective tissue disorders, which cause destruction of the tissues that hold different structures in the body together (i.e., Marfan's syndrome, Ehlers-Danlos syndrome and osteogenesis imperfecta)

Scoliosis can run in families. In addition, females have a higher rate of scoliosis than males (except during infancy).

Scoliosis can progress at varying rates depending on the cause. If your healthcare provider suspects your child has scoliosis, they will check his or her medical and family history. The provider will give your child a physical exam, which may include leaning forward with their palms together. This is done to compare both sides of the body. Differences in limb length will be taken into account.

  • A spinal X-ray may be used to confirm scoliosis and determine its severity. In some cases, additional tests and a neurological examination may be necessary.
  • Experts do not all agree on whether children without risk factors should be screened for scoliosis.

Most spontaneous spinal curves in children (idiopathic scoliosis) are not severe and do not need treatment. However, scoliosis caused by a neuromuscular disorder typically gets worse so treatment needs to be started as soon as possible. Some treatment options include:

  • Periodic observation and measurement, to see if scoliosis is progressing.
  • A scoliosis brace, called an orthotic, which may be needed for a child who is still growing. The goal is to stop a curve from getting worse as the child grows. This is not the same as a brace that is sometimes used to treat low back pain.
  • Corrective surgery, which may be recommended for a severe spinal curve. This may involve bone grafts and metal plates, screws or other metal devices to join two or more vertebrae together. An internal rod may be used to hold the fused and grafted bones in place.
  • Physical therapy, chiropractic care, biofeedback and vitamins have not been found to be helpful.

Make an appointment with your healthcare provider if you think you may have scoliosis.

  • Bring a copy of your medical history (past illnesses, surgeries, and hospitalizations).
  • Make a list of your medications (including over-the-counter).
  • Write down any questions, symptoms or concerns you want to talk about.

Here are some questions to ask your child's healthcare provider:

  • What is my child's diagnosis and what treatment are you recommending? Are there any alternatives?
  • What tests does my child need? What is the reason for those tests? Will the test results change their treatment plan? If not, do they need the tests?
  • What are the follow-up plans and what symptoms should we report before my child's next appointment?
  • If your health care provider refers you to a surgeon for evaluation for a scoliosis brace or possible surgery, ask if he or she is a spine surgeon with experience in treating persons with scoliosis.
  • When you visit the surgeon, ask him or her how many patients with scoliosis he or she has treated with a brace; how many he or she has treated with surgery; and what the results of treatment have been.

Make sure you understand your child's treatment plan, any possible alternatives, and what medications are recommended (including possible side effects). If surgery is recommended, you should understand why that recommendation was made. Seek a second opinion if necessary.

Source UHC.com

Also known as:

Spine
Spinal Curvature
Scoliosis - Office Visit
Curved Spine
Curved Back
Back Pain


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