INTRODUCTION AND DEFINITION
Childhood scoliosis is spinal curvature during growth; the commonest type is idiopathic, though congenital and neuromuscular causes also occur.
This page provides general patient information rather than an individual diagnosis. Decisions depend on symptoms, examination findings, relevant tests and patient preferences. Two people with the same diagnosis may require different care plans.
CAUSES AND SYMPTOMS
Uneven shoulders, a rib hump or waist asymmetry may be noticed, often without significant early pain.
The intensity of symptoms does not always match the extent of changes seen on scans. New significant weakness, walking difficulty or changes in bladder or bowel control require urgent medical assessment.
DIAGNOSIS AND ASSESSMENT
The Adam forward-bend test and standing full-spine X-rays with Cobb measurement assess the curve; remaining growth is crucial.
Assessment begins with the clinical history and an appropriate examination of strength, sensation and reflexes. X-rays, MRI, CT or nerve studies are used when they can answer a specific clinical question. A scan report alone does not establish the need for surgery.
TREATMENT OPTIONS
Small curves are monitored, and bracing may help growing children at risk of progression.
Management depends on the underlying cause, severity, overall health and realistic goals of treatment. Depending on the condition, monitoring, nonoperative care, activity modification, rehabilitation or clinician-selected medication may be considered. No single treatment suits everyone.
SURGICAL PROCESS WHEN INDICATED
Larger or progressive curves can require surgery; effects of fusion on growth and movement are discussed with the family.
Before surgery, the team should discuss likely benefits, alternatives and individual risks. Depending on the operation, complications may include bleeding, infection, anesthesia problems, nerve or spinal cord injury, and persistent symptoms; no outcome can be guaranteed.
RECOVERY AND POSTOPERATIVE PERIOD
Return to school and sport depends on the treatment and child’s development, with long-term monitoring important.
Follow-up, movement restrictions and return to work or sport vary with the procedure and neurological findings. New or worsening weakness, fever, wound drainage or bladder and bowel changes require prompt medical review.