Scoliosis is a sideways curvature of the spine. Normally, the spine looks straight when viewed from behind. People with severe scoliosis have a noticeable “S” or “C” shaped curvature of their spines. In less severe cases, the curve is not so apparent, but an unevenness of the shoulders or waist may be noticed. The first indication of curvature may be difficulty in fitting clothes properly or unevenness in the hem of skirts or slacks. True scoliosis does not disappear as the child attempts to stand straighter, which differentiates it from poor posture.

Scoliosis in children is usually painless. For this reason, pediatricians, family doctors, and school nurses examine children for deformity even in the absence of symptoms.

For the majority of patients, scoliosis has no known cause (“idiopathic scoliosis”). This is in contrast to children with birth defects of the spinal column (“congenital scoliosis”) and to those with neurological problems (“neuromuscular scoliosis”). Idiopathic scoliosis usually begins in adolescence. Idiopathic scoliosis is not a result of bad posture, poor diet, or anything that a parent or child has done.

In mild curves, or in those children whose growth is nearly complete, observation is often appropriate. Although the risk of worsening deformity is low in mild curves and in patients near maturity, only repeat exams can ensure that treatment is not needed.

Bracing is often used in children with moderate curvature. Surgery is required only in severe cases or in those curves which worsen despite bracing.