A scoliosis diagnosis can raise a lot of questions. Learn essential scoliosis facts about this common, treatable condition. If your child has a spine that curves sideways in the shape of an “S” or “C” (instead of an “I”) they may have scoliosis. While scoliosis can sometimes run in families, most cases in children are idiopathic, meaning the exact cause is unknown. Because a person can’t “feel” that they have mild or moderate scoliosis, many people have it and don’t even know. But despite common misconceptions, scoliosis is not caused by anything in your child’s or your family’s lifestyle. Scoliosis can appear in babies or in early childhood, but it most often develops between ages 10-18, when rapid growth spurts can cause curves in the spine to progress. While boys and girls are diagnosed at similar rates, girls are more likely to develop larger curves that require treatment. Fortunately, advancements in care have made it easier than ever to manage scoliosis effectively. Early diagnosis is key—when scoliosis is caught and treated in its early stages, there’s a strong chance of stopping the curve’s progression and avoiding surgery. Let's cover 10 essential facts you need to know as a parent or caregiver to ensure your child receives the best possible care. 1. Scoliosis is common Scoliosis is one of the most common spinal deformities. This condition affects 2-3% of the U.S. population. This equates to about three in every 100 Americans, or an estimated 6-9 million people. Your child may have been born with scoliosis (congenital scoliosis), they may develop it later in childhood (idiopathic scoliosis) or it may have been caused by other conditions like cerebral palsy and spina bifida (neuromuscular scoliosis). Idiopathic scoliosis is the most common type in the world. If your child has been diagnosed with scoliosis, it may be reassuring to know that while there is no cure, it can be very effectively managed. With early detection and proper treatment, most children with scoliosis can live active, healthy lives without any significant limitations. Advances in bracing techniques and non-surgical treatments are helping to slow or even stop the progression of spinal curves, reducing the odds that your child will ever need surgery. With ongoing research and improved treatment options, scoliosis care continues to evolve, offering hope and better outcomes for children and their families. 2. The causes of scoliosis are mostly unknown While idiopathic scoliosis has no clear cause, extensive research, including studies conducted here at Children’s Hospital of Philadelphia (CHOP), has shown that genetics play a role, and scoliosis can run in families. There is a 30% chance of developing it if a close relative has the condition. Scoliosis is driven by uneven (asymmetric) growth of the spine—the front of spine (the anterior) grows faster than the back. This asymmetric growth causes the spine to curve and turn inward (lordosis). Because scoliosis is related directly to growth, this makes the rapid puberty growth spurt a high-risk time for the curve to become rapidly worse. Scoliosis is not caused by external factors like poor posture, carrying heavy backpacks or playing sports. In many cases, it develops gradually, with early symptoms that can be difficult to detect. As a parent or caregiver, you should look for subtle signs in your child, like uneven shoulders, a shoulder blade sticking out, one hip appearing more pronounced or clothing hanging unevenly on their body. Scoliosis affects both boys and girls, but research shows that girls are significantly more at risk for significant progression. Girls are also eight times more likely to experience a worsening spinal curvature, increasing the likelihood that they will need treatment. Because of this higher risk, regular screenings and early intervention are especially important for girls to prevent progression and reduce the need for more invasive treatments like surgery. 3. Adolescent idiopathic scoliosis starts just before puberty Adolescent idiopathic scoliosis is typically detected between ages 10-18, during a child’s peak growth years. Because scoliosis often develops gradually and without pain, regular screenings are essential for early detection. Children usually have their spines checked as part of their annual physical with their pediatrician and, in many cases, by a school nurse as well. These routine exams help identify any signs of abnormal curvature early, allowing for timely intervention before the condition progresses. If your child is diagnosed with scoliosis and the curve is mild, your doctor will likely recommend checkups every 4-5 months to monitor any changes in the position of your child’s spine. 4. See a specialist if you notice a difference in the sides of your child’s body Early detection of idiopathic scoliosis is vital for us to effectively manage your child’s spinal curves and keep them from progressing. If you, a nurse or your pediatrician notice any differences in the sides of your child’s body (asymmetry) in their shoulders, shoulder blades, spine or pelvis, it’s important to have them evaluated by a specialist. Common signs of scoliosis include: Uneven shoulder or hip heightA head that isn’t centered with the bodyOne shoulder blade sticking out more than the otherMost importantly, when bending forward, one side of your child’s back may also appear higher than the other (this is the screening test pediatricians use) If you or your pediatrician suspect your child could have scoliosis, a pediatric spine specialist can perform an X-ray to confirm the diagnosis and measure the degree of curvature. Catching scoliosis early allows for timely intervention, which can help manage the condition effectively and reduce the likelihood of your child needing surgery in the future. At CHOP, children with suspected scoliosis are evaluated by expert pediatric orthopedic physicians in our Spine Program who specialize in spinal conditions. These specialists will conduct a thorough medical history, a comprehensive physical examination and a visual assessment of your child’s spinal curvature. Our dedicated spinal team is experienced in diagnosing and treating all forms of scoliosis and providing access to advanced treatment options including bracing, physical therapy and innovative exercise programs designed to slow curve progression. 5. Early diagnosis is key Early diagnosis is key when it comes to scoliosis. Timely intervention can help prevent the need for surgery. In cases where a growing child’s spinal curve is 25 degrees, the bracing is started. Medical advances in recent years, especially here at CHOP, have provided children with more treatment options than ever before. Modern, custom-made braces that fit the body’s shape in all directions (three-dimensional) have been shown to stop the curve from getting worse in 95% of cases. With the use of advanced imaging techniques, including X-rays that use minimal radiation, and more precise bracing methods, treatment can begin earlier and lead to better long-term outcomes. When scoliosis is detected early, the likelihood of needing surgery decreases significantly, and children are more likely to live healthy, active lives. But early detection is still a challenge, since less than half of U.S. states require scoliosis screening in schools. If left undiagnosed, severe scoliosis can lead to chronic back pain and even interfere with heart and lung function. It is important for parents, teachers and healthcare providers to learn to recognize the signs of scoliosis so they can ensure timely diagnosis and treatment for children who need it. The sooner scoliosis is addressed, the better the chances for successful management and avoiding more invasive procedures. 6. Your child should wear the brace as recommended Properly wearing a brace as instructed by a scoliosis specialist will ensure the best possible outcome for your child. Braces are custom designed in three dimensions (height, width and depth) for your child to provide the necessary curve correction for their specific curve. When your child’s spine requires bracing, it’s essential to discuss the most effective option with your scoliosis doctor, who will choose a brace that your child is most likely to wear as prescribed. In many cases, the recommended wear time is 17 hours a day during the fastest phase of growth. The brace is then weaned down progressively to nighttime only near the end of growth. When growth is complete, bracing stops. Wearing the brace for the full amount of time recommended each day is essential. Many children who wear the braces as recommended complete treatment with a curve smaller and more harmless than when they started. Advancements in bracing technology have made braces more comfortable and less noticeable than ever before. Unlike older, bulkier braces, modern options are often lightweight and discreet. This can make them easier for your child to wear without feeling self-conscious. Although it may feel uncomfortable at first, most children adjust to the brace quickly. During the bracing process, CHOP doctors will continue to monitor your child’s progress. To get a true picture of how their scoliosis is progressing, we ask that the brace be removed two days before an X-ray. This gives their spine time to return to its natural shape, so the results aren’t affected by the brace.
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