Scoliosis: Treatable If Caught Early

By Jason D. Cohen, MD, FACS


Does your child have an excessive curvature of the spine? If so, they may have scoliosis. Scoliosis is an appreciable lateral curvature of the spine and rotation of the vertebrae around the long axis of the spine. It is a deformity that can be either very minimal or very severe. As the degree of scoliosis increases, it can:

  • Become more cosmetically worrisome
  • Begin to affect lung function
  • Cause further problems in adulthood

How is scoliosis detected?

The easiest way to detect scoliosis is to see the curvature of the back. At that time, your child should be referred to an orthopaedic physician. The physician will perform a general inspection, looking at the shoulders and waistline for symmetry, noting any differences. The next portion of the exam is called the “bending” test. The patient places their palms together and bends forward. The spine is then viewed from the front and back.

Additionally, the spine is palpated to feel for a curve. During this test, the ribs will become more prominent on one side. Another method to measure scoliosis is to use a scoliometer (spinal level) to measure rotation of the spine during the bending test. This can be recorded and repeated at a later date to compare and look for any progression.

What are the appropriate treatments?

Treatments for scoliosis will vary based on the patients’ age, location of the curve and the underlying cause of deformity. X-rays should be taken so that the magnitude, location and type of scoliosis can be determined. The X-ray is also important in determining the skeletal age of the patient and how much growth remains. It may be necessary to take a series of X-rays ranging anywhere between three months to one year.

Generally, small curves within 10-20 degrees are observed over time for any increase in size. Bracing is used for curves greater than 20 degrees or curves that have documented progression of greater than 5 degrees. Curves greater than 45 degrees are treated with spinal fusion surgery. Children with scoliosis can lead normal active lifestyles during any phase of treatment and after the surgical treatment as well.