Scoliosis is a curve of the spine that is sideways when viewed from the front. The most common cause in adolescence is idiopathic (causes not specifically known). Other causes include congenital and neuromuscular conditions such as spina-bifida, cerebral palsy, and muscular dystrophy. In later adulthood, degenerative scoliosis is the most frequently diagnosed type. Some curves are very mild and require no treatment other than regular observation. The earlier the curve develops, however, the more likely it is to progress and require treatment.
The symptoms may be difficult to spot. In youth with scoliosis, pain is usually not present. Screening in elementary school or detection by a school nurse or the child’s pediatrician is sometimes the first indication of scoliosis. You may also notice uneven shoulders, breast asymmetry, a change in posture (one hip higher than the other) or a change in the way clothes fit.
A positive family history for scoliosis may be a tip-off to watch rigorously and regularly for any changes, as noted above.
X-rays show bones and are the best tool for characterizing scoliosis. Specialized x-rays that go from the neck to the pelvis are usually necessary to understand the complete curve.
With persistent back and leg symptoms that are unbearable or have lasted longer than a month, an MRI may be necessary. MRI scans may identify any unusual causes of scoliosis.
There is debate about whether or not bracing in childhood and adolescence can prevent the progression of scoliosis. Some doctors believe that once the curve reaches a certain degree bracing should be used to try to prevent the scoliosis from progressing to a surgical range, but this is controversial.