What Are Causes of Scoliosis?
In most cases, the cause of scoliosis is unknown (what doctors call idiopathic). The non-idiopathic types generally fall into two groups:
- Nonstructural (functional): This type of scoliosis is a temporary condition when the spine is otherwise normal. The curvature occurs as the result of another problem (from one leg being shorter than another, muscle spasms due to a soft tissue injury, ruptured disc, or abdominal problems, such as appendicitis).
- Structural: In this type of scoliosis, the spine is not normal. This may be due to abnormally shaped vertebrae or neuromuscular diseases.
- About 30% of children with idiopathic scoliosis have a family history of the condition, but the exact hereditary (genetic) association is not known at this time.
What Are Risk Factors for Scoliosis and Progression of Scoliosis?
Risk factors for idiopathic scoliosis and its progression (worsening of the curvature) include the following:
- Female gender
- Family history of scoliosis
- Bone age significantly less than chronologic age
- Progression of the curve despite bracing or the child not wearing the brace (called noncompliance)
- Presence of scoliosis before puberty, due to the longer time span until completion of bone growth: Generally, the greatest risk of scoliosis progression is in the two years after the onset of puberty, during the time of the rapid adolescent growth spurt. In girls, this is generally in the two years immediately after the age of the first menstrual period (called menarche), usually beginning around age 12. As puberty is generally later in boys, their growth spurt begins around age 13.
What Are Scoliosis Signs and Symptoms?
These signs and symptoms may be seen with idiopathic scoliosis:
- The head may be off center and does not line up with the pelvis.
- One hip or shoulder may be higher than the other.
- The child may walk with a rolling gait.
- The opposite sides of the body may not appear level.
- The child may experience back pain or tire easily during activities that require excessive trunk (chest and belly) movement.
- One side of the rib cage or lower back may seem more prominent (humpback).
- The chest may seem sunken in on one side, or in girls, one breast may seem smaller than the other.
- The child may appear to have an uneven waist.
The physical deformities may not be readily apparent, as adolescents tend to be more modest as they mature and the parents may not see the child's back unless a bathing suit or similar attire is worn.
Medically Reviewed by a Doctor on 12/13/2016
Aimee V. HachigianGould, MD
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