What is Scoliosis?

Scoliosis is a condition in which a child’s spine curves from side to side so that it looks more like an S or a C than a straight line. These curves can also make the shoulders, waist, or hips look uneven. It may look as if the child is leaning to one side. The curve can happen on the right or left side of the spine, or it can happen on both sides in different sections. Both the middle (thoracic) and lower (lumbar) spine may be affected.

When there is no known cause (as in more than 80% of cases), the condition is called idiopathic scoliosis. It is most commonly seen in girls ages 10 to 18, but children of all ages and genders can get idiopathic scoliosis. Scoliosis falls into three general age brackets:

  • Infantile (birth to age 3): More common in boys; may resolve as the child grows.
  • Juvenile (ages 3 to 10).
  • Adolescent (ages 10 to 18): Most common in girls.

Another kind of scoliosis, known as neuromuscular scoliosis, is less common. Neuromuscular scoliosis can develop in patients with other conditions, including:

Our combined team of neurosurgeons and orthopedic surgeons have more years of experience treating both idiopathic and neuromuscular scoliosis than any others in the Bay Area.

What are the symptoms of scoliosis?

Scoliosis usually doesn’t cause much pain. Small spine curves often go unnoticed by children and their parents and are first detected during a school screening or by the child’s pediatrician during a regular checkup.

Symptoms of scoliosis include:

  • One shoulder is higher than the other, or one shoulder blade sticks out more than the other.
  • The head is slightly tilted to one side of the body.
  • The child’s body leans to one side.
  • One leg is longer than the other.
  • One hip sticks out more than the other.
  • The rib cage seems uneven or crooked—one side sticks out more than the other or creates a hump on one side of the back when leaning over.
  • The arms hang beside the body differently when the child stands straight.
  • The heights of the sides of the back are different when the child bends forward.

These symptoms may seem like other back problems, or they may be a result of an injury or infection. Ask your child’s pediatrician about a diagnosis.

What causes scoliosis?

Carrying heavy bags, poor posture, or sports don’t cause scoliosis. In fact, more than 80% of scoliosis cases don’t have a known cause. A child may be born with it or can develop it later in life. Scoliosis is most often seen in children between the ages of 10 and 18, and it tends to affect more girls than boys.

Possible causes of scoliosis include:

  • Nervous system problems, like cerebral palsy or muscular dystrophy.
  • Inherited conditions (passed on from parent to child).
  • Differences in leg lengths.
  • Injury.
  • Infection.
  • Tumors.

How is scoliosis diagnosed?

Your child’s pediatrician can diagnose scoliosis with a complete health history of your child and a physical exam. Your child may also need an x-ray to measure the degree of spinal curvature.

Finding scoliosis early is important for treatment. If left untreated, scoliosis can cause problems with heart and lung function. Health care providers, and even some school programs, routinely look for signs of scoliosis in children.

How is scoliosis treated at Stanford Medicine Children’s Health’s Pediatric Spine Center?

The goal of treatment is to stop the curve from getting worse and prevent deformity. Treatment may include:

  • Observation and repeated exams. Your child will need frequent doctor visits to monitor any ongoing curvature of the spine. Whether the curve gets worse depends on the amount of skeletal growth, or how skeletally mature your child is. Curving of the spine often slows down or stops after a child reaches puberty.
  • Bracing. If your child is still growing, a brace may be part of the treatment.
  • Surgery. Your child may need surgery when the curve measures 45 degrees or more on an x-ray and bracing has not slowed down the progression of the curve.

Scoliosis: What is it and how is it treated?

In this video, hear from Meghan Imrie, MD, a pediatric orthopedic surgeon and spine specialist at Stanford Medicine Children’s Health, about how scoliosis is diagnosed and treated, and what patients can expect. 

Watch the video

Nonsurgical scoliosis treatment options

We take a conservative, nonsurgical approach to treating scoliosis, and we consider other treatments first, such as Schroth physical therapy, bracing, and casting.

We work with your child and family to select the best treatment option for your child’s needs. This can include physical therapy, which is often available in the same location as our clinic team. We have two physical therapists certified in the Schroth method. We also offer integrative pain management techniques as well as osteopathy. Lucile Packard Children’s Hospital Stanford has the only osteopathic physician in the country who focuses on pediatric pain. He sees patients before or after surgery, or if your child doesn’t need surgery but has chronic pain.

If bracing or casting is needed, we offer a variety of options, including Mehta casting for early-onset scoliosis and traditional braces. Our center partners with the Align Clinic for fully customized braces. This company is the only certified maker of Rigo-Cheneau braces in the Western United States. On-site orthotists—experts in making and fitting braces—are available in our Palo Alto and Pleasant Hill locations to save you a trip and to ensure close consultation with our doctors for the best possible fit.

Surgical scoliosis treatment

If surgery is necessary, we will discuss all possible options in detail with you. We perform a variety of surgeries, including well-established techniques like spinal fusion, as well as innovative procedures. For example, for children with early-onset scoliosis, we may be able to use casting with magnetic technology rods called MAGEC growing rods. After one surgical procedure to install the MAGEC rods, they can be lengthened using a magnet in a 10-minute office visit. This helps to straighten and lengthen the spine without requiring additional surgery.

Nearly all surgical procedures are reviewed by our multidisciplinary team to make sure that the most efficient and appropriate technique is used for your child.

Radiation reduction during scoliosis treatment

Since many children with scoliosis need 20 or more x-rays to track the progression of their spine curve during treatment, we offer the EOS low-dose imaging system, which delivers 1/50th of the radiation of a typical spine x-ray. EOS captures both the front and side views—from head to toe—of your child’s body at the same time. This 3-D image helps our scoliosis experts make more accurate diagnoses and allows them to better track your child’s progress throughout treatment. EOS images also show the interactions between your child’s spine, hips, and legs, providing a more complete picture of your child’s condition and helping us develop a personalized treatment plan. Our Palo Alto and Pleasant Hill locations have the only EOS machines in the Bay Area that are dedicated to pediatric patients.

What is life like for patients with scoliosis?

We understand that scoliosis can be a scary diagnosis. Thankfully, the vast majority of patients with scoliosis who are treated go on to live healthy, active, pain-free lives. Most patients with scoliosis can continue to play sports and participate in other activities while they are in treatment and beyond. And as they grow to become adults, most patients don’t have pain.

To learn more or schedule an appointment, please call (877) 463-0001.

Still flexible after scoliosis surgery

An innovative procedure called spinal tethering corrected Audrey's scoliosis while retaining her mobility.

Read her story