Clinical Reference Systems: Pediatric Advisor 10.0
Scoliosis
(Idiopathic Scoliosis)
What is scoliosis?
Scoliosis means that the spine curves somewhat from side to
side rather than being straight down the back. The spine is
made of bones called vertebrae that normally stack one on
top of the other in a straight line.
Scoliosis develops gradually as your child grows. Scoliosis
is usually noticed just before or during puberty when your
child is going through a growth spurt. Girls get scoliosis
more often than boys. Usually parents do not notice the
gradual changes caused by scoliosis. The curvature is
usually discovered by a doctor or school nurse. At first,
the symptoms are painless and not always easy to recognize.
A child with scoliosis may:
- have uneven shoulders or waist
- have a hump on one side of the back
- have one or both shoulder blades sticking out
- lean slightly to one side.
What is the cause?
There are many causes of scoliosis. Sometimes vertebrae are
incompletely formed or misshapen. Sometimes children who
have legs of different lengths will develop a curvature of
the spine. Other times, diseases cause scoliosis. However,
in children and teens the cause is most often unknown. When
a cause for the scoliosis cannot be found, it is called
idiopathic scoliosis.
In idiopathic scoliosis some of the vertebrae are rotated.
This causes the ribs on one side of the back to stick out
more, causing a hump. The muscles attaching the vertebrae
to the ribs on either side may not be pulling with equal
forces. This may cause one set of rib muscles to pull
harder and twist the vertebrae causing them to move out of a
straight line down the back.
How is it diagnosed?
X-rays are taken to diagnose scoliosis. The x-rays show
the amount of curvature and sometimes helps identify a
cause. Your child's legs are measured to make sure they are
the same length.
What are the complications?
The amount of curvature varies widely. However, the younger
your child is when the curvature starts, the worse it is
likely to become. The curving of the spine usually
continues to get worse until a child's bones are done
growing (around age 16 for girls and age 18 for boys). Girls
tend to have more severe scoliosis than do boys. A
curvature in the upper back tends to get worse faster than
one in the lower back. Some curvatures, if allowed to
continue, can cause serious health problems or back pain
later in life.
How is it treated?
If your child has a slight curvature, she just needs
regular checkups by the doctor. If the curvature continues
to get worse, your doctor may recommend braces and molded
plastic shells called orthoses. Orthoses usually slow down
further curving of the spine but do not correct the
curvature that is already there. Sometimes orthoses do not
slow the curving enough to prevent serious problems and
surgery is needed.
Call Your Child's Physician During Office Hours If:
- You would like more information about scoliosis.
For more information see:
Scoliosis: Book List
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