Published on 9 October 2022
Scoliosis affects 2% of the population, with the majority of cases diagnosed during childhood. How does the condition affect children and how can we manage it?
Scoliosis is a condition that causes the abnormal curvature of the spine. While it
can be recognised as early as in utero, this spinal deformity is most commonly
diagnosed during childhood or adolescence when growth spurts occur.
“Paediatric scoliosis is a growing disorder of the spine, where a normally straight
spine, when viewed from the front or back, grows sideways, forming either an ‘S’
or ‘C’ shaped spine. The asymmetrical growing of the spine creates an
unevenness of the body surfaces, resulting in shoulder imbalance, rib
prominence, and waistline asymmetry,” explained Dr Lau Leok Lim , Senior
Consultant, Division of Spine Surgery, Department of Orthopaedic Surgery ,
National University Hospital (NUH).
The causes of paediatric scoliosis are largely unknown, but three main types
have been identified in children:
•
Idiopathic scoliosis: The most common type of scoliosis in children.
The reason for this occurrence is unknown.
•
Congenital scoliosis: The individual bones are not formed or
separated properly from birth.
•
Neuromuscular scoliosis: Caused by underlying medical conditions
that affect the muscles or nerves, such as muscular dystrophy or
cerebral palsy.
Additionally, the most common form, idiopathic scoliosis, can be further
sub-categorised based on the age of the patient when the condition occurs:
•
Infantile idiopathic scoliosis: from birth to three years
•
Juvenile idiopathic scoliosis: from three to nine years
•
Adolescent idiopathic scoliosis: from 10 to 18 years
“The most common diagnosis encountered is adolescent idiopathic scoliosis,
which is present in 2% of our population. Scoliosis is most commonly diagnosed
during growth spurts. For girls, this is often between the ages of 11-14, and for
boys, between 13-16,” said Dr Lau.
Awareness and detection
Early detection is key for patients with any form of scoliosis, as it determines the
suitable course of action.
“The management strategies differ substantially among the types of scoliosis. In
infantile scoliosis, some of the curve patterns are reversible with appropriate
treatment, including body casting or a brace,” shared Dr Lau.
“[Whereas] in juvenile scoliosis, observation or a brace may be recommended. In
more severe situations, growth-friendly technologies such as magnetic driven
growing rods may also be recommended to control the curve and prevent it
from getting worse.”
As scoliosis in children rarely causes any back pain, it may be tricky to notice the
symptoms. Dr Lau advised parents and caretakers to look out for signs in their
children, such as asymmetrical shoulder blades or waistlines.
Important:
Parents seek professional advice should they suspect the presence of scoliosis
Warning signs to look out for
Asymmetrical
shoulder blades
Asymmetrical
waistlines
Abnormal rib
protrusion
In females,
one breast
may appear
higher
than the other
Scoliosis
is commonly diagnosed
during
growth spurts
Boys
Age: 13-16
Girls
Age: 11-14
Idiopathic
Congenital
Neuromuscular
Least common type
Present at
birth
Individual
spinal bones
are not formed/separated properly
Worsens with
growth
Most common type
Can occur during
infancy adolescence
Condition often worsens during
growth spurts
A
symmetrical pull of muscle
forces around the spinal structures
Commonly affects patients with
underlying muscle
or nerve
conditions
(cerebral palsy or muscular dystrophy)
Some patients may be
wheelchair-dependent
Population statistics
7/10
are
female
2
%
population
have scoliosis
of the
There are
3 main types
of paediatric
scoliosis
