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Scoliosis, an abnormal curve to the spine, is commonly found in adolescents.

Of every 1,000 children, 3 to 5 develop spinal curves that are severe enough to need treatment. Scoliosis occurs rarely in adults. Sometimes, it's a worsening of a condition that began in childhood but wasn't diagnosed or treated. In other cases, adult scoliosis may result from a degenerative joint condition in the spine.

Usually scoliosis is painless. Most cases are mild, requiring only follow-up and observation. In more severe cases, the spine can rotate as well, resulting in prominent ribs on one side of the body and narrowed spaces between ribs on the other. Severe scoliosis can cause ongoing back pain and difficulty breathing. Surgery may be necessary.

Signs and symptoms

Signs of scoliosis may include:

  • Uneven shoulders

  • Prominent shoulder blade or shoulder blades

  • Uneven waist

  • One hip elevated as compared to the opposite side

  • Leaning to one side


Very young children may have scoliosis, but adolescent idiopathic scoliosis — which is scoliosis of unknown cause with onset at 10 years of age or older — is the most common type. Doctors define scoliosis in a particular person based on a number of factors related to the curve, including:

  • Shape. Aside from appearing like the letter C or S, a curve may occur in two or three dimensions. A nonstructural curve is a side-to-side curve. A structural curve involves twisting of the spine and occurs in three dimensions.

  • Location. The curve may occur in the upper back area (thoracic), the lower back area (lumbar) or in both areas (thoracolumbar).

  • Direction. The curve can bend to the left or to the right.

  • Angle. Doctors figure out the angle of the curve using the vertebra at the apex of the curve as the starting point.

  • Cause. About 80 percent of scoliosis cases are idiopathic, meaning the cause is unknown.

Many theories have been proposed regarding the causes of scoliosis. They include connective tissue disorders, hormonal imbalance and abnormality in the nervous system.

Scoliosis runs in families and may involve genetic (hereditary) factors. But researchers haven't identified the gene or genes that may cause scoliosis. Doctors also recognize that spinal cord and brainstem abnormalities play a role in some cases of scoliosis.

Risk factors

Most scoliosis is of unknown cause (idiopathic), but there does appear to be a developmental connection in many cases. Most cases of scoliosis occur just before and during adolescence, when children are going through a growth spurt.

Infantile idiopathic scoliosis (ages 0 to 3 years) is more common in boys, whereas juvenile idiopathic scoliosis (ages 3 to 10 years) and adolescent idiopathic scoliosis (ages 10 years and up) are more common in girls.

Risk factors for curve progression in scoliosis include:

  • Sex. Girls are more likely to experience curve progression than are boys.

  • Age. The younger the child when scoliosis appears, the greater the chance of curve progression.

  • Angle of the curve. The greater the curve angle, the higher the likelihood that it will get worse.

  • Location. Curves in the middle to lower spine are less likely to progress than those in the upper spine.

  • Spinal problems at birth. Children who have scoliosis at birth (congenital scoliosis) may experience rapid advancement of the curve.

When to seek medical advice

The onset of scoliosis is gradual and almost always painless, and a significant curvature can develop without the parent or child knowing it. Early detection is important to prevent the curve from progressing.

Unfortunately, the condition usually progresses during the same time that children become more self-conscious (ages 10 to 16) and avoid exposure, so parents and others are not likely to see the problem. Have your child examined if you notice any of the signs of scoliosis.

Scoliosis has the potential to lead to serious health problems, such as severe back pain, difficulty breathing, physical deformity, and injury to the lungs and heart. Be sure to have your child see your doctor if you have a family history of scoliosis.

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