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Idiopathic Scoliosis in Children and Adolescents

A three-dimensional structural curvature of the spine of unknown cause that develops during growth, classified as infantile, juvenile, or adolescent idiopathic scoliosis (AIS), and managed with observation, bracing, or surgery based on curve magnitude, skeletal maturity, and progression risk.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

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This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Çocuk Sağlığı ve Hastalıkları department. Book Appointment →

What is Idiopathic Scoliosis in Children and Adolescents?

Idiopathic scoliosis is a structural lateral curvature of the spine with vertebral rotation, defined as a Cobb angle greater than 10 degrees on standing posteroanterior radiograph in a child without identifiable underlying cause; adolescent idiopathic scoliosis (AIS) accounts for the majority of cases and presents during the pubertal growth spurt.

Risk of progression depends on curve magnitude at diagnosis, skeletal maturity (Risser stage, peak growth velocity), and curve type; girls have higher risk of progression than boys, and curves greater than 25 degrees in skeletally immature patients are at high risk.

Treatment is individualized by curve magnitude and growth potential: observation for curves less than 25 degrees, bracing (Boston, Providence, Rigo-Cheneau) for progressive curves 25 to 45 degrees in immature patients, and surgical correction (posterior spinal instrumentation and fusion or vertebral body tethering in selected cases) for curves greater than 45 to 50 degrees.

Symptoms

Asymmetric shoulders, scapulae, or waistline noticed by parents or on school screening
Rib hump or paraspinal prominence on Adam forward-bending test
Apparent leg-length asymmetry or pelvic tilt
Clothing fitting unevenly or asymmetric breast development in girls
Mild back discomfort with prolonged activity (rare in idiopathic scoliosis)
Reduced exercise tolerance or pulmonary symptoms in severe untreated curves

Risk Factors

Family history of scoliosis (5 to 10 fold increased risk in first-degree relatives)
Female sex (significantly higher risk of progression)
Skeletally immature patient (Risser 0-2) at diagnosis
Larger curve magnitude at presentation (>25 degrees)
Double major or thoracic curves (higher progression risk than single lumbar curves)
Premenarchal girls or boys with significant remaining growth

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Asymmetric shoulders, waist, or rib prominence on Adam forward-bending test on school screening
  • Suspected scoliosis in a child with family history or rapid growth phase
  • Documented progression of a curve more than 5 degrees on serial radiographs
  • Curve greater than 20 degrees in a skeletally immature patient
  • Pain, neurologic symptoms, or atypical features suggestive of secondary causes (referral for MRI)

Treatment Methods

01
Standing posteroanterior and lateral radiographs of the entire spine for Cobb angle measurement, with serial follow-up every 6 to 12 months in immature patients
02
Bracing for curves 25 to 40 degrees in skeletally immature patients (Risser 0-2), worn 16 to 23 hours per day, with quality-of-life support and physical therapy
03
Schroth and Scientific Exercises Approach to Scoliosis (SEAS) physiotherapy as adjunct or stand-alone in selected mild to moderate curves
04
Posterior spinal fusion with pedicle screw instrumentation for curves greater than 45 to 50 degrees, with goals of correction, balance, and lifelong stability
05
Vertebral body tethering as a fusionless growth-modulation alternative in selected skeletally immature patients with idiopathic curves and acceptable flexibility

Which Department to Visit?

You can visit our Çocuk Sağlığı ve Hastalıkları department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Çocuk Sağlığı ve Hastalıkları Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.