Idiopathic scoliosis is an abnormal curvature of the spine that appears in late childhood or adolescence. Instead of growing straight, the spine develops a side-to-side curvature, usually in an elongated “S” or “C” shape; the bones of the spine are also slightly twisted or rotated.
Adolescent idiopathic scoliosis appears during the adolescent growth spurt, a time when children are growing rapidly. In many cases the abnormal spinal curve is stable, although in some children the curve is progressive (meaning it becomes more severe over time). For unknown reasons, severe and progressive curves occur more frequently in girls than in boys. However, mild spinal curvature is equally common in girls and boys.
Mild scoliosis generally does not cause pain, problems with movement, or difficulty breathing. It may only be diagnosed if it is noticed during a regular physical examination or a scoliosis screening at school.
Scoliosis can occur as a feature of other conditions, including a variety of genetic syndromes. However, adolescent idiopathic scoliosis typically occurs by itself, without signs and symptoms affecting other parts of the body.
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Idiopathic scoliosis is one of three different types of scoliosis that cause the spine to develop an abnormal curve.
Although idiopathic scoliosis can occur at any age, it frequently becomes an issue during pre-adolescence and adolescence when children are growing rapidly. “Early onset scoliosis” refers to idiopathic scoliosis that occurs before adolescence. There are three types of idiopathic scoliosis:
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Infantile idiopathic scoliosis is diagnosed in children between birth and 3 years of age. Infantile scoliosis accounts for fewer than 1 percent of all pediatric cases.
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Juvenile idiopathic scoliosis is diagnosed in children between 3 to 9 years of age. Juvenile scoliosis accounts for 12 to 20 percent of all pediatric cases.
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Adolescent idiopathic scoliosis is diagnosed in children between the ages of 10 and 18 years old. Approximately 80 percent of all pediatric cases of idiopathic scoliosis fall into this category.
With early detection, idiopathic scoliosis can be monitored and treated early. In many cases, early treatment can prevent the condition from becoming severe enough to require surgery.
Symptoms
During a child’s growth spurt, the signs of idiopathic scoliosis often become more noticeable. These include:
• uneven shoulders
• one shoulder blade protruding more than the other
• ribs more prominent on one side
• uneven waistline
• difference in hip height
Idiopathic scoliosis is often first discovered during a pediatric checkup or school screening. This is particularly true in children who wear loose-fitting clothes that might cover up the symptoms. If a pediatrician or school nurse suspects your child has scoliosis, they may recommend an evaluation by a pediatric orthopedist or spinal specialist.
Causes
The term “idiopathic” means that the cause of this condition is unknown. Adolescent idiopathic scoliosis probably results from a combination of genetic and environmental factors.
Studies suggest that the abnormal spinal curvature may be related to hormonal problems, abnormal bone or muscle growth, nervous system abnormalities, or other factors that have not been identified.
Researchers suspect that many genes are involved in adolescent idiopathic scoliosis. Some of these genes likely contribute to causing the disorder, while others play a role in determining the severity of spinal curvature and whether the curve is stable or progressive.
Although many genes have been studied, few clear and consistent genetic associations with adolescent idiopathic scoliosis have been identified.
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