June is National Scoliosis Awareness Month.

Scoliosis occurs when the spine is curved abnormally towards the left or right, usually greater than 10 degrees, and twisted or rotated. This abnormal curvature can worsen during a growth spurt in children.

There are many causes of scoliosis, which can be broadly divided into two groups:

. Idiopathic scoliosis – meaning the reason is unknown. Idiopathic scoliosis can occur in infants or adolescents.

. Scoliosis due to known causes like neuromuscular, congenital, or syndromes.

The most common type, which will be the focus here, is Idiopathic Scoliosis which occurs in 80 – 85% of cases and is commoner in adolescent girls.

What may suggest scoliosis in your child?

. Uneven rounded shoulders

. Leaning to one side. 

. Exaggerated upper body curvature.

. Mild to moderate back pain.

How is the diagnosis made?

. Physical Examination of the back and spine.

. X-ray of the spine.

How is scoliosis treated?

Treatment depends on the degree of curvature of the spine. This degree is measured from the x-ray of the spine. There are three broad interventions.

Firstly, observation with close monitoring every 6-12 months by the Pediatrician during clinic physical examination with or without an x-ray. This is usually for spine curvature 20 degrees and below. Scoliosis-specific exercises like Schroth, Scientific Exercise Approach to Scoliosis (SEAS), etc., can be done during this time. 

The second intervention is using back braces, which prevent the worsening of the curvature in children who are still growing. If spine curvature is above 25 degrees, then bracing is an option. Braces are worn between 13 – 18 hrs a day. A team of Orthopedic surgeons, physiotherapists, and Orthotist is involved in your child’s care. Your child can play most sports while using the brace, except for swimming and gymnastics. The use of a back brace is stopped at the end of growth.

Surgery is the 3rd intervention and is used for spine curvature that is 50 degrees or more. The Orthopedic Surgeons do this. It involves the fusion of the affected spine region with metal rods and screws. Your child can resume most sports participation after surgery between 6-12 months. However, collision sports like football, hockey, and rugby may not be permitted, and gymnastics and dancing may be difficult to perform.

Lastly, since idiopathic scoliosis occurs mainly in adolescence, it is imperative that, as parents, one is aware of this condition’s tremendous impact on self-image at this age. Supporting and encouraging your adolescent’s compliance with treatment plans is important. Your child may benefit from counseling or patient support groups during this time.