There are many types of scoliosis. About 90 percent
of patients with scoliosis have a type known as idiopathic scoliosis.
We do not know what causes this type of scoliosis, but the "trait"
for it tends to run in families. Other types of scoliosis are associated
with neurologic, muscular, and bone diseases.
When scoliosis first develops it is usually not
painful. One of the first signs of scoliosis is a change in
physical appearance. Common physical findings are one shoulder or
one hip may be higher than the other side, an abnormal "crease"
at the waist, or dresses and skirts may appear to have a crooked
hemline. When a patient with scoliosis is viewed from behind while
bending forward at the waist, a "rib hump" is frequently visible
next to the spine.
Many cases of scoliosis are first discovered by
the patient or a family member. In the state of Kentucky, all school
children in the sixth and eighth grade school children are screened
for scoliosis and spinal deformities if parental permission is given.
Several cases of scoliosis are discovered this way. Also, family
physicians and pediatricians can diagnosis scoliosis on physical
Once the presence of scoliosis is suspected, a
physician can order a spinal x-ray to confirm the diagnosis. The
degree and the type of the curvature can be determined from the
Treatment of idiopathic scoliosis is largely dictated
by the degree of the curvature and by the age and skeletal maturity
of the patient. In growing children and teenagers, small curves
(10º to 25º) can be treated with observation. Moderate
curvatures (25º to 40º) are frequently treated with a
spinal brace to prevent progression of the curvature. When curvatures
are greater than 45º, a spinal fusion procedure is sometimes
necessary to prevent further curve progression and to correct the