Spinal curvature (scoliosis) typically appears during the growth spurt in children just before adolescence. Although scoliosis may result from conditions such as cerebral palsy and muscular dystrophy, the cause of most scoliosis cases is unknown. Approximately 3% of the adult population has scoliosis. Most cases of scoliosis are mild, but some spinal curvatures can become more severe as children grow. Severe scoliosis can lead to health problems. Particularly, a severe spinal curvature can reduce the amount of space within the chest, resulting in decreased respiratory capacity and lung problems. In this article, we will discuss spinal curvatures that occur during adolescence.
Scoliosis is generally more common in girls than in boys. Although having scoliosis in the family increases the risk, many scoliosis patients do not have a family history of spinal curvature. The curvature can progress rapidly during children’s growth spurt period.
If your child has uneven shoulder levels, a hump on one side of the lower back in particular, pelvic bones that are not at the same level posteriorly, or asymmetric shoulder blades, scoliosis should be suspected. Lower back pain is generally not present in scoliosis; if there is lower back pain, other conditions that cause spinal pain should be investigated along with scoliosis.
When scoliosis is suspected, you should consult an orthopedics and traumatology specialist. After an orthopedic examination, an X-ray film is taken to include the entire spine to determine the degree of curvature. The degree of curvature is measured on the film by the physician. If the child has pain along with the curvature and additional findings are detected during the doctor’s examination, further evaluation with MRI or computed tomography may be necessary.
For a patient diagnosed with scoliosis, a follow-up and treatment program is created by the specialist physician for the family. There are two important factors for the follow-up and treatment program. The first is the child’s age, and the second is the degree of curvature. Children diagnosed with scoliosis at a young age have a higher likelihood of increased curvature when there is more growth remaining in their height; therefore, younger children are called for more frequent follow-up. Especially in children who have completed adolescence and growth, follow-up can be done with annual evaluations.
According to the degree of curvature, we can classify scoliosis as mild, moderate, and severe. Progression of mild curvatures is monitored with X-ray films taken at 6-month intervals in pre-adolescent and adolescent patients. Exercises targeting especially the back and lower back muscles are initiated in these patients. For children who have completed their growth with mild curvatures, if there are no complaints during follow-up, monitoring is not necessary.
In moderate spinal curvatures, pre-adolescent and adolescent patients should be monitored more closely according to the degree of curvature. The risk of progression of the curvature is higher in these patients. For these patients, the use of a curvature-correcting brace along with a special exercise program may be necessary. The torso brace to be used is custom-made for the patient. These braces need to be worn 23 hours a day. According to the recommendation of the specialist physician monitoring the patient, this duration can be reduced to as little as 14 hours. In moderate curvatures, the goal of treatment is to reduce the progression of the curvature until the child completes their growth, preventing it from reaching severe scoliosis levels. In some patients, the degree of curvature in the spine may decrease with exercise and brace treatment, but complete correction of the curvature is not expected.
Severe scoliosis has the potential to progress even in adulthood. It can create an imbalance in the patient’s torso. Therefore, it causes back and lower back pain in these patients in advancing years. It also bothers many patients cosmetically. Scoliosis surgery may be necessary in these patients. It is more appropriate for scoliosis surgery to be performed in centers specialized in this field.
Medical Disclaimer: This information is for educational purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider for diagnosis and treatment options specific to your condition.