By Drs. Sally Robinson and Keith Bly

Scoliosis, a condition that causes the spine to curve too much in the wrong direction, affects approximately 6 million people in the United States. The condition develops gradually and often is not detected until a child is between 10 and 14 years old. No one knows what causes the most common type of scoliosis, idiopathic (meaning “unknown cause”). It is not caused by poor posture, diet, exercise or the use of backpacks. It is thought to be hereditary, so other family members may have it. Though it occurs equally in girls and boys, girls are more likely to develop more severe cases.

A spine affected by scoliosis curves into an “S” or a “C” shape from side to side. When this curve is severe, it can be visible and cause pain. Severe curvature of the spine can lead to other health problems and eventually affect the heart and joints, but in most cases, it is mild enough that it doesn’t require medical treatment.

In some cases, scoliosis is noticeable – one shoulder blade may be higher than the other or the curvature of the spine is visible. Most schools and doctors screen for scoliosis. When a child is diagnosed, your doctor will check his spine regularly (every six to nine months) to make sure the curve does not get worse.

Signs and symptoms of scoliosis include uneven shoulders, one shoulder blade that sticks out farther than the other, an uneven waist, one hip higher than the other, and leaning to one side. Risk factors that can affect the chance that a scoliosis curve will get worse include:

· Gender: Girls are more likely than boys to have greater curvature of their spine.
· Age: If scoliosis appears at a younger age, it is more likely to worsen.
· Angle of the curve: The greater the angle of the curve, the more likely it will worsen.
· Location: Curvature in the mid to lower spine is less likely to worsen than curvature located in the upper spine.
· Spinal problems at birth: Children born with scoliosis are more likely to continue to have problems.

Severe cases of scoliosis may require treatment. Scoliosis is treated with braces that hold the spine in place to keep the curve from getting worse. Some are worn at night, while others are worn during the day.

Sometimes a child with scoliosis may need surgery to correct the curvature of her spine. This surgery involves fusing the bones in the spine together using metal rods, hooks, screws and wire to hold everything in line until the bones heal. The operation takes about six hours. A child who undergoes this operation will be able to get out of bed the next day and walk. He will not need to wear a cast or a brace after the surgery.

If your child is diagnosed with scoliosis at school, call your family doctor to schedule a physical examination.
Dr. Sally Robinson is a pediatrician in the division of children’s special services at the University of Texas Medical Branch at Galveston. She teaches medical students about caring for children with chronic medical conditions. Dr. Keith Bly is a hospitalist and assistant professor of pediatrics at UTMB.

The Your Health column is written by health and medical experts at the University of Texas Medical Branch at Galveston. The column focuses on topical health issues that we believe are of interest to your readers. It is e-mailed every Tuesday. If you have any questions about the column, or would like to suggest topics, please contact John Koloen, media relations specialist, at (409) 772-8790 or email jskoloen@utmb.edu.