Idiopathic scoliosis, the most
common type, does not have a known cause. Children who have this type of
scoliosis usually first develop symptoms in childhood.
Most cases of scoliosis are mild, involving small curves in the spine that do
not get worse. Small curves usually do not cause pain or other problems.
Usually a doctor examines the child every 4 to 6 months to watch for any
In moderate or severe cases of scoliosis, the curves
continue to get worse. During periods of growth, such as during the teenage
growth spurt, the curves may get worse. Curves of less than 30 degrees often
stop progressing when the skeleton stops growing, while larger curves may get
worse throughout adulthood unless they are treated.
1 out of 10 children who are diagnosed with scoliosis require treatment (either
bracing or surgery).2
Factors that may
indicate the potential growth of a curve include:
- The age of the child and the development stage, or maturity, of
his or her skeleton when scoliosis is diagnosed. The less mature the skeleton
is when scoliosis starts, the greater the chance that scoliosis will get worse.
Skeletal age, as determined by the
Risser sign, is also used to determine the risk that
the curve will get worse.
- The size of the curve. The larger the
curve, the greater the risk that it will get worse.
- The location and shape of the curve. Curves in the upper back are
more likely to get worse than curves in the lower back.
Girls are more likely than boys to have larger curves and
more severe scoliosis.
As scoliosis gets worse, the bones of the
spine rotate toward the inner part of the curve. If the upper part of the spine
is affected, the ribs may crowd together on one side of the body and become
widely separated on the other side. The curve may force the space between the
spinal bones to narrow. The spinal bones may also become thicker on the outer
edge of the curve.
In severe curves, misshapen ribs may reduce the
amount of air the lungs can hold and may cause the heart to work harder to pump
blood through the compressed lung tissue. Over time, this can lead to
Although it is uncommon,
babies can be born with scoliosis (congenital) or can develop it during the
first 3 years of their lives (infantile scoliosis). Scoliosis that is present
at birth or that develops in infants may be worse in the long run than
scoliosis that develops later in life. This is because the more growing the
skeleton has to do, the worse the curve may get. But in some cases
congenital curves do not get worse, and some curves that are present during
infancy get better on their own without treatment.
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