What is scoliosis?

If your teen has scoliosis, it means that her spine is curved sideways. This curve can lead to changes
in her shoulders, ribcage, pelvis, waist, and the overall shape of her back. The sketch below shows
what a spine with scoliosis looks like.

Scoliosis
With scoliosis, the spine curves to
one side, usually to the right, resulting
in one shoulder being higher than the
other.
Your teens surgeon will measure the size of her curve. The curve may be small, medium, or large in
size:

Small curves are 20 degrees or less.

Medium curves are between 20 and 50 degrees.

Large curves are greater than 50 degrees.

There are three main types of scoliosis. These are congenital scoliosis, neuromuscular scoliosis, and
idiopathic scoliosis.
An X-ray can show whether the bones in your teens spine are mis-shaped or not. If the bones are
mis-shaped, your teen has congenital scoliosis. If the bones in her spine are normally shaped, the
surgeons then need to find out if there is an underlying cause for the scoliosis. If there is an
underlying cause, it is probably related to a muscle disease or condition, and therefore is referred to
as neuromuscular scoliosis. If there is no underlying cause for the scoliosis, it is referred to as
idiopathic scoliosis. The word idiopathic means of unknown cause.

Congenital scoliosis
The word congenital means present at birth. If your teen has congenital scoliosis, it means that the
bones in her spine were not shaped properly from birth. The mis-shaped bones in her back have
caused her scoliosis. However, her actual curve may not have developed until later in childhood due to
abnormal growth.
The seriousness of the curve varies from teen to teen. Your teen may have developed large curves in
her spine in her early years of life. On the other hand, she may have developed just a small curve in
her teenage years.
If your teen has congenital scoliosis, she might have problems in other areas of her body as well.
Almost 25% of teens with congenital scoliosis have problems with their kidneys or urinary tract. Ten
per cent have congenital heart disease, which is heart disease from birth.
This website will focus on idiopathic scoliosis, which is described below.

Neuromuscular scoliosis
If your teen has neuromuscular scoliosis, it means that her spine curve is caused by a muscle disease
or condition. One condition that can cause scoliosis is muscular dystrophy, which weakens the
muscles. Another is cerebral palsy, which causes constant muscle contractions.
If your teen has neuromuscular scoliosis, the curves in her spine may get bigger and lead to more
problems. For example, a teen with neuromuscular scoliosis might find it hard to sit on her own. If she
has a large curve and weak rib muscles, she may have problems with breathing.
Neuromuscular curves are usually diagnosed during childhood. Many of the conditions that cause
neuromuscular scoliosis are genetic and involve many parts of the body. This is different from
idiopathic scoliosis which only involves the spine.

This website will focus on idiopathic scoliosis, described below.

Idiopathic scoliosis
The word idiopathic means of unknown cause. If your teen has idiopathic scoliosis, it means that her
spine is curved sideways and there is no known cause. Teens with idiopathic scoliosis are healthy in
every other way.
Will your teens curve get bigger?
There are several factors that will affect whether your teens curve will progress. For example, her
curve is more likely to increase if she is very young, especially if she has not yet reached puberty.
Will your teens curve need treatment?
The need for treatment depends on the type and size of her curve. In general:
If your teen has a small curve of less than 20 degrees, she may only need to be observed over
time.

If her curve is medium-sized, between 20 to 50 degrees, she may either be observed over
time or treated with a brace.

If she has a larger curve, greater than 50 degrees, she may require surgery.

This website will focus on idiopathic scoliosis. Specifically, it focuses on idiopathic scoliosis that may
require surgery.
Sandra Donaldson, BA
Reinhard Zeller, MD, ScD, FRCSC
6/1/2008