Everything you should know about Scoliosis

Scoliosis is a very common spine condition that affects 2 to 3 percent of the population, or about 6 to 9 million people in the United States alone. Scoliosis is a lateral curvature of the spine that most commonly affects teenagers. It can develop in adults who have cerebral palsy or muscular dystrophy, although the origin of most childhood scoliosis is unknown.

While most cases of scoliosis are usually mild, it can worsen for some children as they grow older. When this happens, scoliosis can potentially become a debilitating condition. The amount of room in the chest can be reduced due to a particularly severe spinal curve, making it difficult for the lungs to function correctly.

Mild scoliosis patients must be regularly monitored by a reliable spine doctor. It is recommended to have regular X-ray exams to see if the curve is worsening. In many circumstances, there is no need for treatment. However, some patients need to wear a brace to keep the curve from getting worse. Furthermore, some cases could require surgery to correct extreme curvature.

What are the signs you or your child may have Scoliosis?

Scoliosis can go unnoticed especially when a patient does not experience pain or other complications. If you want to know if you or your child may have it, watch out for these signs:

  • Unbalanced shoulders
  • Uneven waist
  • One shoulder blade looks more prominent than the other
  • One side of the hip is elevated
  • A protruding rib cage on one side
  • When leaning forward, one side of the back is noticeably more prominent

In the majority of cases of scoliosis, the spine rotates or twists in addition to curving side to side. This results in one side of the body’s ribs or muscles protruding more than the other side.

What causes Scoliosis?

While doctors are still unsure of the source of the most prevalent type of scoliosis that affects children, it appears to be inherited, as the illness occasionally runs in families. On the other hand, less prevalent forms of scoliosis may be caused by:

  • Certain neuromuscular disorders, such as cerebral palsy and muscular dystrophy
  • Birth abnormalities that impact the development of the spine’s bones
  • Previous surgery on the chest wall in childhood
  • Spinal injuries or infections
  • Anomalies of the spinal cord

Furthermore, one may be more at risk of developing scoliosis due to the following factors:

  • Age. Adolescence is usually when signs and symptoms begin.
  • Sex. While boys and girls develop mild scoliosis at roughly the same rate, girls face a significantly greater chance of having worse curvature, with most requiring treatment.
  • Family history. Scoliosis can run in families, however, it is found that the majority of children with the disorder have no family history.


What are the complications associated with Scoliosis?

Although most patients do not report serious problems related to scoliosis, some seek the help of spine doctors in Fort Lauderdale due to complications, such as:

  • Breathing difficulties. Severe scoliosis may cause the rib cage to press against the lungs, making it difficult to breathe.
  • Back pain. Adults who have scoliosis as children may be more likely to suffer from chronic back pain, particularly if their abnormal spinal curve is significant and untreated.
  • Appearance. There are more noticeable changes as scoliosis gets worse. This can include a shift in the waist and torso to one side, uneven hips, and prominent ribs. People with scoliosis can become self-conscious about how they look.


How is Scoliosis diagnosed?

To diagnose scoliosis, the doctor will conduct a thorough medical history and inquire about recent growth. In order to determine whether one side of the rib cage is more prominent than the other, your doctor may ask you or your child to stand up and then bend forward from the waist with arms hanging loosely.

A neurological exam may also be performed by your doctor to look for:

  • Weakness in the muscles
  • Numbness or lack of sensation
  • Abnormal response or reflex

Imaging Tests

There are many ways to confirm the diagnosis of scoliosis, and conventional X-rays are among them. However, because many X-rays need to be taken over time, repeated radiation exposure may become a cause for worry.

Alternatively, your physician may recommend a less radiation-intensive imaging technique for creating a 3D model of your spine. However, not all medical facilities use this method. Scoliosis severity can also be determined with the use of ultrasound, although this method is less accurate.

If your doctor suspects an underlying problem is causing the condition, such as an anomaly in the spinal cord, they may suggest an MRI scan.

What are the treatment options for scoliosis?

Treatment options for scoliosis differ according to the severity of the bend. Children with extremely mild curves typically do not require treatment. However, they may require periodic examinations to determine whether the curve is increasing as they age.

If the spinal curve is moderate or severe, bracing or surgery may be required. The following factors must be considered:

  • Maturity. If a child’s bones have stopped developing, spine curvature development will also stop. Braces are most effective on children whose bones are still growing. 
  • Curve’s severity. More severe curvatures are likely to worsen over time.
  • Sex. Girls face a far greater risk of curvature advancement than boys do.


Depending on the severity of scoliosis, your doctor may recommend a brace for your child. Even though braces can’t completely correct the curvature of the spine, they can at least slow its progression.

The brace will be removed once the child stops growing. In general, girls reach the end of their growth spurt around the age of 14, while boys do so around the age of 16, but this varies greatly from person to person.


For patients with severe scoliosis, your doctor may recommend scoliosis surgery to help correct the curve and keep it from worsening.  Among the surgical options are:

  • Spinal fusion. Two or more vertebrae (bones in the spine) are fused together in this treatment so that they cannot move on their own. 
  • Expanding rod surgery. Expandable rods can be implanted along the spine of a child who is showing signs of rapid progression of scoliosis in order to slow the curve’s progression. The rods are extended every three to six months via surgery or remote control.
  • Vertebral tethering. This technique is done through tiny incisions. Screws are inserted along the perimeter of the abnormal spinal curve and a strong, flexible cord is threaded through them. The spine straightens as the cable is tightened. The spine may straighten further as the child grows.


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Trust one of the Top Spine Surgeons in Palm Beach County

If you spot symptoms of scoliosis in your child, do not delay consulting our pediatric spine doctor. Mild curves might form without you or your child’s knowledge because they develop slowly and seldom cause pain. Teachers, friends, and sports buddies are often the first to observe a child’s scoliosis.

Schedule an appointment with Dr. Hepler, our orthopedic spine surgeon in Delray Beach and Fort Lauderdale, so he can evaluate your condition, provide an accurate diagnosis and develop the best treatment plan for you. 

Our spine surgeon, Dr. Matthew Hepler, has extensive knowledge and experience in diagnosing and managing scoliosis, as well as other conditions like spinal stenosis, compression fractures, and disk herniations, among others. He is well versed in performing a wide range of treatment options, including 

Get in touch with us today to learn more about our services and to schedule a consultation!

Below are a list of case examples which Dr. Hepler has treated:

Case Example 1: 17 woman with progressive adolescent curve despite bracing.

Case Example 2: 38 yo woman with untreated adolescent scoliosis that has progressed over the years and came to include disabling back pain.

Case Example 3: 17 yo young male with progressive scoliosis and imbalance despite non operative treatment with bracing.

Case Example 4: 16 yo girl with progressive scoliosis despite bracing.

The material contained on this site is for informational purposes only and DOES NOT CONSTITUTE THE PROVIDING OF MEDICAL ADVICE, and is not intended to be a substitute for independent professional medical judgment, advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare providers with any questions or concerns you may have regarding your health.