Scoliosis factsheet

Introduction

Scoliosis is when the spine is curved sideways instead of being straight. Sometimes, the spine also twists vertically.

In most cases, the cause of scoliosis is not known. This is called Idiopathic scoliosis, which usually starts during growth spurts in childhood or adolescence.

This type is based on the age it starts to develop:

Infantile – before 3 years old
Juvenile – between three and 10 years old
Adolescent – after 10 years old.

Other types include:

Congenital scoliosis - when the curve in the spine is present at birth
Neuromuscular scoliosis – linked to conditions like cerebral palsy or muscular dystrophy.

Scoliosis is more common in girls than in boys.

Signs and symptoms

Scoliosis may show as:

head not centred over shoulders
uneven hips or shoulders, one higher than the other
an uneven ribcage
a deeper waist on one side
the body leaning more to one side.

Diagnosis

Your child’s doctor will diagnose scoliosis based on:

your child’s signs and symptoms
results from scans, like X-ray, CT or MRI
results from the forward bending test – your child leans forward to touch their toes with straight legs to see if the back is even.

Treatment

Treatment options will depend on the:

age of your child
type of scoliosis
severity of scoliosis.

Monitoring

Mild scoliosis is often monitored with regular check-ups to see if the curve worsens over time.

Bracing

A brace, such as a TLSO (thoraco-lumbo-sacral orthosis), can help stop the curve from worsening while your child grows.

It is a hard medical device that is worn 16–20 hours a day under clothing. The brace pushes against your child’s back to stop the curve from getting worse.

It is used for curves between 20 and 40 degrees. Your child’s doctor will talk to you about what kind of brace your child needs to wear and how long they need to wear it.

Casting

For children under six, a plaster cast may be used to help straighten the spine. This is usually applied under general anaesthetic, so your child is asleep and does not feel any discomfort.

The cast is worn for about six weeks and may be replaced several times.

Surgery

Severe scoliosis may need surgery to:

straighten and stabilise the spine
prevent it from worsening.

There are different surgery techniques and tools that can be used, including steel rods or screws to hold the spine in place.

Your child’s surgeon will talk to you about the best option and answer any questions.

Scoliosis