Scoliosis in children

What is scoliosis?

  • Scoliosis in simple terms means a crooked spine.
  • The normal spine curves in and out when you look from the side and looks straight from the back.
  • In scoliosis, the spine curves side-to-side when you look at it from the back. This gives an “S” or “C” shape to the spine.

Who is affected by scoliosis?

The causes of scoliosis can be due to genetic factors, abnormal growth of the spine during puberty and muscle or bone diseases.

The types of scoliosis include:

  1. Congenital scoliosis where the baby is born with an abnormal spine.
  2. Neuromuscular scoliosis which is due to an abnormal brain (such as in cerebral palsy), spinal cord problems (such as spina bifida) or diseases of the muscles (such as muscular dystrophy).
  3. Degenerative scoliosis which is due to previous spinal surgery, trauma or diseases.
  4. Idiopathic scoliosis where the exact cause is unknown. It is also the most common type of scoliosis. This type generally affects girls more than boys.

What are the signs and symptoms?

Sometimes the scoliosis can be quite obvious. The child or teenager will have :

  • one shoulder that is higher than the other.
  • one shoulder blade may be more prominent than the other.
  • an uneven waist line.
  • one pant leg that is shorter than the other, or
  • an abnormal rib cage which is more protruding on one side.

Problems that may occur if the scoliosis is severe are :

  • back pain,
  • difficulty in breathing,
  • problems with digestion, or
  • problems with movement.

If you suspect your child to have these symptoms, you will need to consult your doctor for further evaluation.

How is scoliosis diagnosed?

  • You can do a simple test called a forward-bending test and it does not hurt at all.
  • It involves bending forwards while standing up with straight knees and you can see whether there is a prominent hump on one side of the back.
  • If you see the hump, you will need to consult your doctor and he or she may ask you to do a spine x-ray to look at how many degrees the spine is curved.

How is scoliosis treated?

  • If the degree of curve is mild, there is no treatment required.
  • If your child is still growing, your doctor might want to see your child regularly to monitor the degree of the curve.
  • If your doctor feels the curve of the spine is getting worse, your doctor may refer your child to the orthopaedic surgeon.
  • The orthopaedic surgeon may prescribe a body brace especially if your child is still growing.
  • The body brace does not permanently correct the curve of the spine. The brace is there to prevent the curve from getting worse.
  • Some braces are designed to be worn at night only while some are designed to be worn both day and night.
  • Sometimes surgery is done when the scoliosis is severe. This is usually done by fusing the bones in the spine together and using metals and rods to hold them in place till the bone heals.

What is the outlook?

  • Children with mild scoliosis can do exercises such as swimming or stretching exercises. These exercises do not correct the curve but it improves overall health and well-being.
  • Once your child has stopped growing and the curve remains mild, the outlook is generally positive.
  • There are no known exercises that can worsen scoliosis but if your child has severe scoliosis, it would be better to discuss with your doctor what exercises to avoid.
  • If your child needs surgery for his or her scoliosis, your child will generally be able to return to normal activities by 6 to 12 months. Once the bones fuse, there will be no progression of the curved spine.
  • Children with scoliosis have a positive outcome even if they have surgery as they have better self-esteem and able to do most normal activities in life.
Last Reviewed : 03 January 2014
Writer : Dr. Cham Weng Tarng