• Scoliosis is a sideways curvature of the spine that makes the spine look more like an "S" or "C" than a straight "I".
• Scoliosis can cause the bones of the spine to turn (rotate) so that one shoulder, scapula (shoulder blade), or hip appears higher than the other.
• The term "idiopathic" means that the cause of this disorder is not known (in most cases).

Understanding the spine can help you better understand scoliosis. Learn more about spine anatomy at Spine BasicsSpine Basics (topic.cfm?topic=A00575)

• Frequency of scoliosis:
• Scoliosis curves measuring at least 10° occur in 1.5% to 3.0% of the population
• Curves exceeding 20° occur in 0.3% to 0.5% of the population
• Curves exceeding 30° occcur in 0.2% to 0.3% of the population
• Small spinal curves occur with similar frequency in boys and girls, but girls are more likely to have a progressively larger scoliotic curve that will require treatment.

• In most cases of scoliosis, the exact cause is not known (idiopathic). However, scoliosis can occur in several people within a family. When it does, there is probably a genetic component to its cause.

• Scoliosis can occur at any age.
• Adolescent idiopathic scoliosis occurs after the age of 10 years. It is the most common type.
• Infantile scoliosis occurs in children less than 3 years old. It may result from abnormally shaped vertebrae at birth (congenital), various syndromes, neurologic disorders, or unknown reasons (idiopathic).
• Juvenile scoliosis occurs in children between the ages of 3 and 10 years. It is not common

• Scoliosis does not usually cause any pain, neurological dysfunction, or respiratory problems. The concern over the cosmetic appearance of the back often is the primary concern of the patient and parents.

• The doctor will ask your child to bend forward, which will show any deformities (see the image above). This is called the "Adam's forward bend test." He or she will also check for any limb-length discrepancies, abnormal neurological findings, or other potential causes.

Many schools regularly conduct scoliosis screenings of students. These screenings usually occur during the middle school years. Your child may receive a referral for scoliosis to a doctor based on the results of a school screening.

Scoliosis is confirmed with an x-ray of the spine. Your doctor will measure the degree of the curve, as shown in the accompanying x-ray.

If left untreated, curves exceeding 50° can lead to problems in the long term. Progressive deterioration of the scoliotic curve can occur, which in some patients can lead to diminished lung capacity and the development of restrictive lung disease. Cosmetic concerns are significant to many patients. The incidence of back pain among patients with scoliosis is similar to that of the general population.

• The type of treatment required depends on the kind and degree of the curve, the child's age, and the number of remaining growth years until the child reaches skeletal maturity.

If the curve is more than 45° and the child is still growing, the doctor may recommend surgery. If the patient has reached skeletal maturity, surgery may still be recommended for scoliotic curves that exceed 50° to 55°.

At present, the main research focus in idiopathic scoliosis is investigation into genetic factors as a cause of scoliosis.