• This colored x-ray shows sideways curvature of the spine characteristic of scoliosis.

  • About 1.5% of adolescent aged 14 years or older develop scoliosis, with the condition more common in girls than boys. Routine school screening programs now exist in all 50 states, and typically consist of a physical exam.

  • The forward bending test can help clinicians identify scoliosis, particularly when one shoulder appears to be higher than the other, or the pelvis appears to be tilted. Because the degree of the curve identified during the exam may underestimate the actual curve, any child with a curve should be referred for x-ray. Other symptoms may include: backache or low-back pain; fatigue; shoulders or hips appear uneven; abnormal lateral spine curve.

  • Clinicians should fit any patients with a greater than 25 to 30 degree curve for a back brace to slow the progression of the curve and straighten the spine. Bracing does not work for congenital or neuromuscular scoliosis, and is less effective in infantile and juvenile idiopathic scoliosis.

  • The necessity of spinal fusion surgery, a surgical correction in which bone grafts and metal rods are used to straighten the spine, varies depending on the severity of the patient’s scoliosis and how well they respond to other treatments. Surgeons may decide to wait until a child’s bones stop growing before performing surgery; however, patients with curves greater than 40 degrees generally require surgery.

  • This colored X-ray shows a steel plate pinned onto the lumbar spine, to correct scoliosis. Five steel pins connected by a plate have been screwed into affected vertebrae to immobilize them.

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Scoliosis is a curving of the spine that worsens with growth spurts. Scoliosis begins as a sideways curvature of the spine that typically begins in childhood and progresses to an S-shaped curve. There are three general etiologies: congenital, neuromuscular and idiopathic.

Congenital forms of scoliosis occur in the womb or during early life and involve deformities of the vertebrae or ribs. Neuromuscular scoliosis results from muscle weakness or paralysis, which can occur with diseases including cerebral palsy, muscular dystrophy, spina bifida and poliomyelitis.

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