When you look at the normal spine from the front or the back, the spine should appear straight. But, when you have scoliosis, the spine has an “S”-shaped curve from side to side.
Scoliosis treatment will depend on your age, and how large your curvature is, among other things. Most people with scoliosis live no differently than anyone else, which means they can play sports and be physically active. If, however, a curve becomes worse over time, we may decide to treat the condition with a brace or with spinal surgery.
Reasonably accurate predictions can be made based on the location and size of your curve(s), your age, and your skeletal maturity. There also are new genetic tests that may be used to answer this question. If a curve develops at a young age or before a girl begins her period, there is a greater chance the curve will get worse. On the other hand, the more mature your skeletal system is, the less likely your curve will continue to grow. Mostly, we like to keep an eye on the curve over time to see if it gets worse or not.
Scoliosis often goes unnoticed until a pediatric exam or an in-school screening by a nurse or gym teacher – even if you never noticed anything wrong with your back. In fact, most kids who have this condition don’t feel any pain. During an “Adam’s Forward Bend Test,” you are asked to bend over, and any curvature in the spine becomes more visible. Other signs of scoliosis include: one shoulder that appears higher than the other or unevenness in the hips. A "rib hump," a hump on the back that sticks up when the spine is bent forward, may also point to the presence of scoliosis.
About 10 percent of kids ages 10 to 15 have some degree of scoliosis. Fortunately, most cases of scoliosis at this age involve small curves that don’t require a doctor’s care. While scoliosis appears to be genetic, the cause of most types of scoliosis is still a mystery. Scientists have explored many different theories to explain why some kids get scoliosis while others don't, but we still haven't pinpointed any specific cause. While both boys and girls can get scoliosis, the condition usually progresses much more rapidly in girls than it does in boys.
How your doctor administers scoliosis treatment will depend on your age, how mature your skeletal system is, and how large your curvature is. Most people with scoliosis live no differently than anyone else, which means they can play sports and be physically active. We have many scoliosis treatment options to try to prevent your curve from growing:
Monitoring: If you have a small curve in your spine, we usually recommend regular observation. Most small curves can be monitored without X-rays. If a curve begins to get larger, however, it may be necessary to take X-rays every four to six months.
Exercise: Although exercise will not make your curve better or worse, it does help to keep your muscles flexible. After you find out you have scoliosis, it is important to remain fully active by participating in your usual sports and activities.
Bracing: If you have a medium-sized curve and you are still growing, we may prescribe a brace for your back. We’ll explain how to wear it and answer any questions you may have about it. Like many kids with scoliosis, you might feel a little self-conscious about wearing a brace at first, but braces today are a lot more body conforming than they used to be, and there are ways you can disguise them. The main thing to remember is that it is important to wear the brace every day for the length of time we prescribe (12 to 16 hours daily) Most patients don’t have to wear it to school. This will help to keep the curve in your back from getting bigger. If wearing a brace concerns you, it may help to talk to your parents or caregiver to look for ways to help manage your feelings. We can also give you names and phone numbers of other kids who have been helped by wearing a brace, which can be of help.
If you have a small curve in your spine, it will probably not become much worse once your skeletal system stops growing and you probably won’t need surgery. But, if you do, the most common surgery for scoliosis is spinal fusion. Nearly all spinal fusion surgery uses some type of rod to straighten the spine, and involves fusing two or more vertebrae (bones in the spine) together to provide stability.
The good news is that today’s surgical techniques are less invasive, provide better correction, and result in a quicker recovery than they ever did before.
Each case is unique, but spinal surgery typically lasts from four to six hours.
You should be able to return to school within a few weeks and to resume most of your activities within a few months after surgery. Kids can usually play some sports within six to nine months. Follow-up evaluations are usually scheduled every four to six months.