Scoliosis

Idiopathic means the cause isn't known. Adolescent idiopathic scoliosis can affect a child who's healthy and doesn't have nerve, muscle or other spine problems. It's the most common spine deformity (not a normal shape) we see and affects about 3% of the population. 

Adolescent idiopathic scoliosis affects children between ages 10 to 18. Girls have scoliosis more often than boys. 

There are many theories about why children get scoliosis:

• Genetics: Scoliosis runs in families and you can be born with it.
• Growth: Curves can happen during growth spurts, which can be linked to hormones.
• Structural and biochemical changes: Some studies show increases in muscle movement around spinal curves, sometimes this can be related to legs being different lengths.
• Central and nervous system changes: Some nerve disorders can cause scoliosis.
• Equilibrium and posture: Problems with posture and balance can affect the spine and how it grows.

When scoliosis is diagnosed in children, there is concern that the curves will keep getting bigger.

Each child is different, but it's known that curves in the thoracic spine (the bottom of the neck to the middle of the body) are more likely to get worse than lower back curves. Larger spinal curves are more likely to get bigger and lead to a worse case.

If the scoliosis curves start at a young age or before a girl gets her period, they are more likely to get worse. Note that the higher a child's Risser sign (which measures skeletal maturity) is at diagnosis, the less chance there is of the scoliosis getting worse. 

Scoliosis that's diagnosed after puberty is called adult scoliosis. Adult scoliosis is usually different than the childhood type. It can be caused by childhood scoliosis that wasn't found or treated. 

Most cases of adult scoliosis are idiopathic because the cause is not known. Some adult scoliosis is the result of changes in the spine due to aging and normal wear and tear. 

There are many types of adult scoliosis:

• Idiopathic curve 
• Congenital curve
• Paralytic curve (usually from a spinal cord injury) 
• Myopathic deformity (usually from a muscular or neuromuscular disease, such as muscular dystrophy, cerebral palsy or polio)
• Secondary scoliosis (caused by other spinal problems, such as softening of the bones)

Degenerative adult scoliosis is another type of scoliosis that happens after age 40 because of age and deterioration of the spine. In older female patients, it's often caused by osteoporosis. This can cause the spine to lose its normal shape.

Often back braces and nonsurgical treatment will help scoliosis. Sometimes surgery is needed for more serious cases. Surgery is done to keep scoliosis from getting worse and to straighten the spine.

We always try to find the least invasive treatment plan or the one that requires either no surgery or the simplest surgery possible. Most people don't need surgery.

If your quality of life continues to be affected after nonsurgical treatment, surgery may be the best choice. Our spine surgeon, Sean Keem, MD, is an expert in handling even the most challenging scoliosis cases.