The spine, or backbone, helps hold the body upright. Without its
gentle curving down the back, we wouldn't be able to balance,
walk, or move properly. But for people with a condition called
the spine curves from side to side. And sometimes this can cause
What Is Scoliosis?
The word scoliosis (pronounced: sko-lee-
-sus) comes from a Greek word meaning crooked. If you have
scoliosis, you're not alone. About 3 out of every 100 people
have some form of scoliosis, though for many of them it's not
much of a problem.
Someone with scoliosis may have a back that curves from side to
side like an "S" or a "C." Although small
curves generally do not cause problems, if the curve gets severe it
can be visible and cause discomfort.
Scoliosis is sort of a medical mystery - no one knows what
causes the most common form of scoliosis,
. ("Idiopathic" is a medical term that means it's not
known what caused the condition or disease.) Doctor do know that
scoliosis can run in families, though. So a person who has
scoliosis may have family members who have it. Most types of
scoliosis are more common in girls than boys, and girls with
scoliosis are more likely to need treatment.
How Is Scoliosis Diagnosed?
Sometimes scoliosis will be easily noticeable. A curved spine
can cause someone's body to tilt to the left or right. Many
teens with scoliosis have one shoulder blade that's higher than
the other or an uneven waist with a tendency to lean to one side.
If a curve gets really severe, it can even affect a person's
breathing and heart function and can lead to damage in the joints
of the spine and pain in adulthood.
Because scoliosis can develop very gradually, in most cases it
isn't diagnosed until a person is between the ages of 10 and
Doctors routinely check teens for scoliosis during regular
physical exams. Some schools in the United States also test for
scoliosis, but the most accurate way to diagnose it is to see a
What Do Doctors Do?
After examining you closely, the doctor will decide if further
treatment is needed. If he or she determines the curve isn't a
problem, you may not need any treatment, just regular checkups to
make sure the curve doesn't become larger. If the doctor wants
to get a clearer view of your spine, he or she may order X-rays. If
the doctor's exam or X-rays show a significant curvature,
you'll be referred to an orthopedist.
The orthopedist will examine you and study X-rays of your spine.
You may hear the orthopedist mention something called a
. The Cobb angle is a measure of the curvature of the spine in
degrees, and the number of degrees helps the doctor decide what
type of treatment is necessary. A scoliosis curve of 10 to 15
degrees usually means that nothing needs to be done except for
regular checkups until the person has gone through puberty and
finished growing (the curvature of the spine usually doesn't
get worse after that point). If the curve is 20 to 40 degrees, the
orthopedist will generally suggest a back brace. A Cobb angle of 40
or 50 degrees or more may mean that surgery is necessary.
About 1 in 5 teenagers with scoliosis needs to wear a back
brace. Back braces today are much lighter and more comfortable than
they used to be - and researchers are developing even better ones
all the time.
There are several different types of braces. Some braces are
worn for 18 to 20 hours a day, others only at nighttime. Which one
the orthopedist chooses depends on the person, where the curve is
on his or her back, and how severe the curve is.
The brace acts as a holding device that keeps the spine from
developing more of a curve. A brace won't ever make the spine
straight. But if it does its job well, the curve won't increase
more than 5 or 10 degrees and most people won't need
Sometimes, even with a brace, someone will need surgery to
correct the curve. During the operation, the orthopedic surgeon
does a procedure called a spinal fusion. This causes some of the
separate bones of the spine to link or "fuse" together,
so that the spine can no longer continue to curve. The surgeon also
uses metal rods, hooks, screws, and wires to correct the curve and
hold everything in line until the bones heal. The metal parts are
placed deep under the spine muscles, and in most cases can't be
felt and do not hurt.
An operation to correct scoliosis takes several hours, depending
on how big the curve is and how many bones need to be fused.
Normally, the person will be able to get out of bed the next day
and start to walk. He or she can usually go home in less than a
Teens who have had surgery to correct scoliosis can usually go
back to school about a month after surgery, then return to some
activities in 3 or 4 months. Most people should be able to go back
to all normal activities after 6 to 12 months. But of course each
patient's surgery and recovery might be different, depending on
the type of surgery and the person's age.
After about a year, the bones should have fully fused. Although
the metal rods are no longer needed, they are left in the
patient's back because they aren't doing any harm and
taking them out would involve another operation.
People with scoliosis can have active, normal lives. Doctors
don't know of any activities, including sports, that make
scoliosis worse. So teens who have scoliosis should still be able
to play their favorite sports and carry on as normal (except if
they are recovering from surgery, of course).
Steven Dowshen, MD
Date reviewed: December 2007
Originally reviewed by:
R. Jay Cummings, MD, and William G. Mackenzie, MD
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
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