scoliosis

Scoliosis is a condition characterized by a lateral curvature of the spine, usually measured as a Cobb angle of 10 degrees or more, with vertebral rotation. Most cases are idiopathic, meaning no specific cause is identified, but scoliosis can also arise from congenital vertebral anomalies, neuromuscular disorders, syndromic conditions, or degenerative changes in adults.

Classification commonly distinguishes by age of onset (infantile, juvenile, adolescent) and by cause (idiopathic, congenital, neuromuscular, syndromic, degenerative). Adolescent idiopathic scoliosis is the most frequent form, accounting for the majority of cases. The condition affects about 2-3% of children and is more likely to progress in females when curves are larger or skeletal growth is ongoing.

Signs may be subtle or obvious: uneven shoulders or hips, a prominent rib hump on forward bending, and a leaning posture. Pain is not typical in adolescents, but discomfort can occur in adults. Diagnosis relies on physical examination and imaging. Standing anteroposterior and lateral spinal radiographs determine the curve’s size and shape and allow Cobb angle measurement; MRI is used if neurological signs, rapid progression, or unusual curves are present to evaluate underlying causes.

Management depends on the curve size and growth potential. Mild curves are often observed with regular follow-up. Bracing is used to slow progression in growing children with moderate curves (approximately 25–40 degrees). Surgical options, usually posterior spinal fusion, are considered for large or progressive curves (often >40–50 degrees) or when bracing fails. Growing rods or other growth-friendly techniques may be used in younger patients, with newer approaches like vertebral body tethering in select cases. The goal is to prevent progression and preserve function and appearance.