Adolescent Idiopathic Scoliosis

What it is

Scoliosis is a sideways curve and rotation of the spine. “Idiopathic” means there is no single known cause — it is not from backpacks, posture, sports, or anything you or your child did. It tends to run in families (about 1 in 3 children with it have a relative who had it too) and it appears during the fast growth of the preteen and teen years. It is common: roughly 3 in 100 adolescents have some degree of it. In most children the curve is mild and simply needs watching.

What it looks like

Scoliosis is usually painless and is often first noticed as unevenness rather than as a complaint — one shoulder or shoulder blade higher than the other, a hip that looks higher, an uneven waistline, or a rib hump that shows when your child bends forward. Most teens with scoliosis feel completely well. Significant back pain is not typical of idiopathic scoliosis, so if it is present, I look at it carefully rather than assuming the curve is the cause.

How we measure and follow it

On an X-ray, I measure the curve in degrees (the “Cobb angle”) and I estimate how much growing your child has left — because growth is what drives a curve to worsen. Those two numbers, curve size and remaining growth, decide everything that follows. A mild curve in a child who is nearly done growing behaves very differently from the same curve in a child with years of growth ahead.

How we treat it

Treatment is matched to those two numbers, and most children never need surgery:

• Observation — for smaller curves: we recheck with an X-ray every few months to confirm the curve is holding steady.
• Bracing — for moderate curves in a child who is still growing: a brace does not reverse a curve, but it is proven to stop many curves from worsening into the surgical range. Worn as prescribed, it works.
• Surgery — considered for larger curves (generally once a curve passes roughly 45–50°): the goal is to correct and stabilize the spine and stop progression for life.

The science — for the curious

The reason we watch growth so closely is that idiopathic curves progress mainly while the spine is still lengthening. Most curves slow dramatically once a child reaches skeletal maturity. Larger curves — especially those above about 60° — can keep slowly progressing into adulthood, which is part of why we treat sizable curves before growth ends. This is also a fast-moving field: newer growth-friendly options such as vertebral body tethering are expanding what is possible for the right candidate, and we can talk through whether your child is one.

Learn more

Scoliosis Research Society — Idiopathic Scoliosis: srs.org

Scoliosis Research Society — Patient Brochures: srs.org/patients

This handout is general education about a common condition and does not replace the personalized advice we discuss in clinic about your child’s specific case. If anything here does not match what we talked about, what we talked about wins — please ask me.