Question 1

What is adolescent idiopathic scoliosis?

Accepted Answer

Adolescent idiopathic scoliosis (AIS) is a sideways curvature of the spine that develops during adolescence (ages 10-18), with no known cause (idiopathic). The spine curves to the side forming a C-shape or S-shape when viewed from behind. It's the most common type of scoliosis, affecting 2-3% of adolescents. Females are 7-8 times more likely than males to have curves requiring treatment. Most curves are detected by school screening programs or parents noticing asymmetry (uneven shoulders, prominent shoulder blade). Important: scoliosis is NOT caused by poor posture, heavy backpacks, or how you sleep. It's likely genetic with 20-30% having family history.

Question 2

How do I know if my child needs treatment?

Accepted Answer

Treatment depends on: 1) Cobb angle (degree of curve on X-ray), 2) Skeletal maturity (how much growth remaining - Risser grade), 3) Curve progression. LESS THAN 20-25 degrees: observation only, X-rays every 4-6 months. 25-40 degrees AND still growing: bracing recommended to prevent progression. OVER 40-50 degrees: surgery typically recommended. The challenge: predicting which curves will progress. Risk factors for progression: larger curve at diagnosis, skeletally immature (Risser 0-2), female, thoracic curve pattern. If curve is small and stable, no treatment needed. Your surgeon will monitor with repeat X-rays every 4-6 months during growth.

Question 3

Does the brace actually work?

Accepted Answer

Yes, IF worn as prescribed. Research shows bracing prevents curve progression needing surgery in 70-75% of compliant patients. KEY WORD: compliant. Brace must be worn 18-23 hours per day to work - wearing it only 12 hours or only at night has much lower success rates. The brace does NOT correct the existing curve (won't make it better), it holds the curve from getting worse during growth. Once growth is complete, the curve achieved with bracing is permanent - it won't progress further after skeletal maturity even without brace. Challenge: compliance is difficult for teenagers - visible under clothing, uncomfortable, impacts body image and self-esteem. Psychological support critical for success.

Question 4

Can exercise or physiotherapy prevent progression or avoid surgery?

Accepted Answer

NO - exercise and physiotherapy do NOT prevent curve progression or eliminate need for bracing or surgery. Multiple high-quality studies show exercise alone does not change the natural history of scoliosis. However, exercise is still recommended to maintain flexibility, strength, and fitness. Schroth method (specialized physiotherapy): some evidence suggests may help reduce small curve progression when combined with bracing, but NOT a substitute for bracing in moderate curves. Bottom line: if your child has a 30-degree curve and growing, they need a brace - Schroth exercises may be helpful adjunct but won't prevent progression on their own.

Question 5

When is surgery needed for scoliosis?

Accepted Answer

Surgery typically recommended for: 1) Curves over 40-50 degrees (cut-off varies by surgeon and curve location), 2) Curves 35-40 degrees that are progressing despite bracing, 3) Curves causing significant cosmetic distress even if not meeting angle threshold. Why 40-50 degrees? Research shows curves over 40-50 degrees at skeletal maturity will continue to progress in adulthood (1 degree per year), potentially causing back pain and pulmonary issues if become very severe (over 70-80 degrees). Curves under 40 degrees at maturity typically don't progress in adulthood. Surgery aims to reduce curve and prevent progression. Decision also considers: curve pattern, cosmetic concerns, patient/family preferences, psychological impact.

Medical Disclaimer

Adolescent Scoliosis (Curved Spine)

📖What is Adolescent Scoliosis (Curved Spine)?

🔬What Causes It?

⚠️Risk Factors

You may be at higher risk if:

🛡️Prevention