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Scoliosis

by Robert S. Dinsmoor

A musculoskeletal disorder characterized by a sideways curve of the spine. While people of all ages may have scoliosis, it most commonly occurs in children and adolescents 10 years of age and older.

Scoliosis can have nonstructural causes that may include a difference in leg length, muscle spasms, or inflammatory conditions such as appendicitis. In these cases, treating the underlying problem corrects the temporary curvature of the spine. Structural scoliosis, on the other hand, is a fixed curvature and may be caused by connective tissue disorders (such as Marfan syndrome), neuromuscular diseases (such as cerebral palsy, polio, or muscular dystrophy), birth defects, injury, infection, tumors, metabolic diseases, or rheumatic diseases. In 80% to 85% of affected people, however, scoliosis is idiopathic, meaning that it has no known cause. The doctor diagnoses idiopathic scoliosis only after ruling out other possible causes, such as injury or infection.

In evaluating scoliosis, doctors examine a person’s medical history to find out about injuries, birth defects, or other medical conditions that might be causing curvature of the spine. They also evaluate the curvature during the physical examination. If there is significant spinal curvature, unusual back pain, or signs that the central nervous system is affected (such as bowel or bladder incontinence), the doctor may order an x-ray. The doctor can also use the x-ray to measure the angle of the spinal curvature.

In people who are still growing, with an idiopathic curve of less than 25°, doctors may choose not to treat them and to reexamine them every 4 to 6 months while they’re still growing. In some cases, doctors may prescribe a brace that is worn around the torso and that can help stop a curve from getting worse. In other cases, as when the curvature is severe or getting worse, surgery may be used. The most common type of surgical procedure for scoliosis fuses one or more vertebrae together to stop the curve from worsening and to help straighten the spine. Devices may also be placed in the spine to keep it stable and aligned.

Last Reviewed on October 19, 2011

Robert S. Dinsmoor is a medical writer and editor based in Massachusetts.

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