What is Adolescent Scoliosis?
Adolescent scoliosis is a lateral curve of the spine that appears before the onset of puberty and prior to the full maturation of the spine (adulthood).
As many as 4 in 100 adolescents have idiopathic scoliosis.
Adolescent idiopathic scoliosis is the most common type of scoliosis in children ages 10 to 18. Idiopathic means that there is no apparent cause for the curved spine.
What is the Cause of Scoliosis in Children and Teenagers?
According to the Scoliosis Research Society, there are multiple theories as to what causes adolescent idiopathic scoliosis, such as hormonal imbalance, asymmetric growth and muscle imbalance. Roughly 30 percent of adolescents with idiopathic scoliosis have some family history of scoliosis, which might indicate a genetic condition.
While idiopathic scoliosis is the most common, there are other types of scoliosis affecting children. Congenital scoliosis occurs when vertebrae develop incorrectly in utero. Early onset scoliosis, which occurs before age 10, can be caused by neuromuscular disorders such as spinal muscular atrophy, cerebral palsy, spina bifida and brain or spinal cord injury.
Signs and Symptoms of Scoliosis in Adolescents
Unlike in adults, back pain is not a common symptom of scoliosis in adolescents. Middle schoolers and teenagers might complain of back pain, but this could merely be growing pains, muscle strains that usually get better with time, lack of flexibility, or a sports-related injury.
Patients with adolescent idiopathic scoliosis typically do not experience pain.
- Crooked shoulders (one is higher than the other)
- Head not centers or slightly tilted to one side
- One shoulder seems higher than the other, or “sticks out” more
- Torso leans (a shift of the body to the right or the left)
- One leg seems longer than the other, or one hip “juts out” more
- Child has a “rib hump” on one side of their back when they lean over
Diagnosing & Treating Scoliosis in Adolescents
To diagnose scoliosis, a doctor will perform a physical observation, use a scoliometer to give a rough estimate to the curvature of the spine, and order X-rays if the physician thinks the patient might have a spinal curve of 10 degrees or more.
Dr. Shay Bess, board-certified surgeon at DISC, stresses that the goal of treating scoliosis in children is to stop the curve from progressing.
Typically, treatment isn’t considered necessary until the curvature reaches 25 degrees or more.
Adolescent Idiopathic Scoliosis Treatment
There are three main treatment options for adolescent idiopathic scoliosis.
- Observation — Used for children and teenagers with a curved spine of less than 25 to 30 degrees who are still growing, or those with curves less than 45 degrees who have stopped growing. Many adolescents have curves that never progress past 25 or 30 degrees, so they won’t need to wear a brace. A doctor orders X-rays every 4 to 6 months to determine whether a brace is necessary.
- Brace — A scoliosis brace can halt or slow the progression of the curve. The goal of a brace is to have a patient avoid spinal fusion surgery. According to the Scoliosis Research Society, multiple studies have demonstrated the effectiveness of wearing a brace to slow the curvature of the spine in adolescents.
- Surgery — Surgical treatment is usually recommended for patients with a curved spine greater than 45 degrees while still growing (puberty), or curves continuing to progress greater than 45 degrees after growing stopped (maturation). The goal of surgery is to prevent curve progression and obtain some curve correction.
Scoliosis Specialists for Children and Adolescents in Denver
At Denver International Spine Center (DISC), our board-certified physicians and specialists use the latest research and technological advances to treat children and adolescents with spinal conditions and spine injuries. Dr. Kuklo, spine surgeon at DISC, was the editor-in-chief of the Spinal Deformity Study Group Radiographic Measurement Manual, currently the gold standard in research on spinal care and treatment.
We are committed to providing each patient with the best possible treatment options. At DISC, we offer parents and families a wealth of resources for children and adolescents with scoliosis.