Frequently Asked Questions About Scoliosis in Children

At what age does a child usually develop scoliosis?

Most children with scoliosis are within the adolescent age group, which is defined as greater than ten years of age. In girls, curves usually appear between ten to 13 years of age. Boys have growth spurts later than girls, so the curves generally occur between 12 to 14 years old. In Texas, the school screening program is designed to identify children who have adolescent idiopathic scoliosis. Depending on the school district, the screening usually happens sometime between fifth to ninth grade to identify growth spurts for boys and girls and identify curves that might benefit from treatment.

How common is scoliosis?

Scoliosis is much more common than most people realize. As many as three percent of the population have a small curve in their back, which doesn’t mean they aren’t normal. Many small curves are picked up during the Texas school screening process.

Is there a lot of pain associated with scoliosis?

Most children with scoliosis don’t have a lot of back pain, and they don’t generally have any weakness or neurologic findings, either. Typically, they just have a spine that becomes more crooked as they continue to grow. If your child does have a lot of pain with scoliosis, it may be an indication that there’s something else causing the back pain, such as a tumor or other rare condition.

What is the treatment for large curves?

Contrary to what most people think, there is no alternative treatment for large curves other than braces. For large, progressive curves, a brace program is the only effective treatment, provided the child wears the brace full-time. Full-time brace wear consists of 20-plus hours per day, with the child taking the brace off only for showering, P.E. and sports. For very large curves, braces are not recommended and the only treatment shown to stop progression of large curves is surgery.

Can a patient leave a large curve untreated?

It’s not recommended to leave a large curve untreated, because not only can the curve continue to get bigger, but if the patient does eventually decide to have surgery it will be higher risk, making it more difficult to straighten the curve. The patient may ultimately end up with a result that is not as cosmetically pleasing as it would have been if he or she would have addressed the curve earlier.

Who should seek scoliosis surgery?

Whether or not scoliosis surgery is recommended depends entirely on an analysis of the curve. For children with a curve that is going to be problematic in adulthood, surgery is recommended as a child. Physicians in most countries agree that surgery should take place when a child’s curve reaches 50 degrees, because the vast majority of curves larger than 50 degrees progress as adults. Typically, if a curve is under 50 degrees, surgery is not recommended in childhood.