Scoliosis

Idiopathic, congenital, and neuromuscular scoliosis are not preventable but can be effectively managed with appropriate treatment and scoliosis surgery. Exercise, maintaining a healthy body weight, and the right nutrition plays an important role in preventing degenerative scoliosis. Bone health nutrients including calcium, vitamin D, and phosphorus can help prevent the bone mineral loss that often leads to osteoporosis. Idiopathic scoliosis accounts for about 80% of scoliosis cases. Idiopathic refers to “unknown cause” when all other causes have been ruled out. Congenital scoliosis stems from the malformation of vertebrae that occurs in the embryonic stage. Neuromuscular scoliosis is a consequence of muscular or neurological diseases including spinal cord trauma, spina bifida, cerebral palsy and so on. This type of scoliosis is why many people seek scoliosis surgery. Degenerative scoliosis is an adult-onset scoliosis attributed to the degeneration of the spine due to the normal process of aging or conditions such as osteoporosis, disc diseases, and osteoarthritis.

According to National Institute of Health (NIH), it is possible that genes are involved in idiopathic scoliosis. Researchers have also found evidence that idiopathic scoliosis tends to run in families. According to available data, one-third of adolescents with idiopathic scoliosis have a family history of this condition. There is 11% chance of developing idiopathic scoliosis if first degree relatives have the condition.

American Academy of Orthopedic Surgeons (AAOS), Scoliosis Research Society (SRS), Pediatric Orthopedic Society of North America (POSNA), and American Academy of Pediatrics (AAP) issued a position statement on scoliosis screening. According to these agencies, screening for scoliosis should be done at age 10 and 12 for girls and at age 13 for boys. Scoliosis screening should be “part of the medical home preventative services visit” according to these agencies.

A common myth is that bad posture or slouching causes scoliosis. Although a bad posture and persistent slouching can have a negative impact on the overall health, these do not lead to scoliosis. Scoliosis is also not caused by carrying a heavy rucksack or school bag on one shoulder or carrying heavy loads on both the shoulders. While slouching, carrying weight on one shoulder and so on do not cause scoliosis, they may have other detrimental health effects including resulting in hyperkyphosis which is another type of forward curvature of the spine. With appropriate physical training and posture correction, these types of curvatures can be reversed and prevented.

Children or teens with scoliosis typically do not experience any pain until the curvature of the spine becomes severe. Severe curvature can press against the nerves, ligaments, discs of the spine and facet joints resulting in back pain. At times, teachers, doctors or parents can find mild curvature. It is important to get the child or teen evaluated by a qualified scoliosis surgeon to ensure accurate diagnosis and early intervention.

Surgery is generally reserved for curves that progress beyond 45–50 degrees, or curves between 25–40 degrees that continue to worsen despite bracing. The decision also depends on the patient's age, remaining growth potential, curve location, and whether the curve is affecting lung function or daily activity. At Hunt Spine, surgical recommendations are made only after monitoring progression with serial X-rays, not based on a single measurement.

Yes. While adolescent idiopathic scoliosis is the most common form, adults can develop degenerative (or 'de novo') scoliosis as spinal discs and joints wear down with age, often worsened by osteoporosis or arthritis. Adults with a childhood curve can also see it progress over time. Unlike adolescent scoliosis, adult-onset cases are more likely to cause back pain and nerve-related symptoms, since the spine has less flexibility to compensate for the curve.

Scoliosis severity is measured using the Cobb angle, calculated from an X-ray by drawing lines along the most tilted vertebrae above and below the apex of the curve and measuring the angle between them. A Cobb angle of 10 degrees or more confirms a scoliosis diagnosis, while the angle's progression over time — tracked through repeat X-rays every 4 to 6 months — determines whether bracing or surgery becomes necessary.