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Starship Paediatric Spine Service

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Idiopathic Scoliosis

The most common type of scoliosis is called Idiopathic Scoliosis. It appears in otherwise normal healthy children.

In childhood, idiopathic scoliosis occurs equally in both boys and girls (Early-Onset Scoliosis and Juvenile Scoliosis). However, adolescent girls are up to 10 times more likely to be diagnosed with idiopathic scoliosis than boys of the same age. Girls are also more likely to have curves severe enough to require treatment.

Idiopathic scoliosis may appear at any age but most often commences in the pre-teens or early teens, and may gradually progress as rapid growth occurs. Once rapid growth (puberty) is over, the mild curves often do not change whilst severe curves nearly always progress. By the age of 16 years, 2 - 3% of the population will have a scoliosis measuring 10 degrees (Cobb angle) or greater. 10% of these adolescents will require active treatment.

What is the treatment for idiopathic scoliosis?

There are three basic treatment options for idiopathic scoliosis:

(1)  Observation

A curve of less than 20 degrees is considered mild. This means that nothing needs to be done at this stage. Regular clinical examinations and x-rays will be required to assess changes in the curve measurement. These check-ups are continued until your child is skeletally mature (at the end of puberty).

(2)  Bracing

If your doctor predicts a rapid increase in the curve of your child’s spine, he may recommend a brace. It will not straighten the spine, but it may help to slow progression of the scoliosis. Most scoliosis braces use under-arm ("body jacket") type braces. Braces are made from light-weight polypropylene and most are usually undetectable under clothing. Bracing is only used during years of active growth. It's stopped if the curve progresses into the surgical range (40 to 50 degrees), or if it's successful and your child has reached skeletal maturity. Children can participate in all normal activities without restrictions.

(3)  Surgery

If the curve in your child’s spine continues to increase in severity (above 45 degrees), your doctor may recommend surgery. This is called a spinal fusion. A spinal fusion involves metal implants and bone graft. Spinal implants consist of a variety of metal rods, hooks, wires and screws, which are used to hold the correction of the spine whilst the bone fusion heals. The implants used depend on a number of factors including age of child, type and location of curve.

The aim of surgery is to:

  1. Correct or lessen the curvature and to stabilise the affected area of the spine.
  2. Improve the cosmetic appearance.
  3. Decrease discomfort or postural fatigue.

Facts about idiopathic scoliosis

  • Idiopathic scoliosis is the most common type of scoliosis.
  • Onset can occur at any age but is most commonly seen in children aged older than 10 years.
  • 90% of patients are female.
  • Progression is not inevitable.
  • Predictors of progression include young age, significant curvature and skeletal immaturity.
  • The main aim of treatment is to prevent mild deformity becoming severe.
  • If curvature of the spine is greater than 45° and progressing, surgical intervention is most likely required.

This page was last updated at 2:27PM on May 9, 2019.