Pediatric scoliosis is a sideways spinal curve that can develop in children and teens. Typically, it’s diagnosed in the tween and early teen years. Experts do not fully understand the causes of most childhood scoliosis, and several factors may contribute to scoliosis in children.  

A healthy child’s spine has gentle curves when viewed from the side. A scoliosis curve goes to the side, forming a “C” or “S” shape when viewed from behind. The severity of the spinal curvature and the age of the child at diagnosis are key factors in deciding the best course of treatment.

Children often have no pain, weakness, numbness or other symptoms that point to a curvature of the spine. Scoliosis often is discovered by a parent while the child is undressed or during a routine physical examination by the family doctor.

Side-to-side misalignment that results in shoulder imbalance, chest or rib asymmetry, or leaning side to side may be a result of scoliosis.

Scoliosis doesn’t go away with time or growth of the child — it must be evaluated and corrected by a specialist. Left untreated, scoliosis can worsen and affect the lungs, heart and other internal organs.

Curves tend to continue to increase throughout adult life due to degeneration of the discs, arthritis and poor bone quality. If there is suspicion or a strong family history of scoliosis, a qualified spine specialist should be consulted.

Most children with scoliosis can live active, healthy lives with the right care. Early diagnosis and monitoring are essential — especially during growth spurts.

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Signs and Symptoms of Scoliosis in Children

Look for these common signs in your child:

• Uneven shoulders or a shirt that hangs lower on one side
• One hip higher than the other or sticks out more
• Uneven waistline
• Leaning to one side
• One side of the back sticks out more when bending forward
• Head doesn’t align with the middle of the body

If you notice any of these signs, a visit to a pediatric orthopedic specialist can help determine if scoliosis is present.

Types of Scoliosis in Children

Idiopathic Scoliosis

The most common form of scoliosis in young children, idiopathic scoliosis has no known cause and often runs in families. It occurs 10 times more often in children assigned female at birth. Idiopathic scoliosis is grouped by age:

• Early-onset scoliosis
  • Infantile scoliosis (newborn to age 3)
  • Juvenile scoliosis (ages 4 to 9)
• Adolescent scoliosis (ages 10 to 18) – the most common type

Neuromuscular Scoliosis

This type of scoliosis is related to conditions such as cerebral palsy, muscular dystrophy or spina bifida. It often causes a “C”-shaped curve, spinal rotation that can pull the ribs out of alignment and pelvic imbalances. 

Congenital Scoliosis

Present at birth, congenital scoliosis results from abnormal spinal development during pregnancy. Vertebrae may be missing, fused together or malformed.

Syndromic Scoliosis

Other types of scoliosis are more common in adults, including degenerative scoliosis.

Diagnosing and Monitoring Scoliosis in Children

Scoliosis is diagnosed through a physical exam and imaging, typically X-rays. The Cobb angle is the gold standard diagnostic tool. Using X-ray technology, it measures spine curvature and assigns a degree of mild, moderate or severe. This helps the care team determine next steps for diagnosing and treating the child’s specific spinal condition. 

Children who are still growing are at higher risk for progression of the curve. Catching scoliosis early allows for less invasive treatments and reduces the need for surgery later in life.

Low-dose EOS Imaging for Kids

Frequent imaging often is necessary to monitor scoliosis in children. At Norton Children’s Leatherman Spine, we use EOS Imaging, a state-of-the-art 2D/3D imaging system designed for children.

Benefits of EOS:

• 50% to 85% less radiation than standard X-rays
• Up to 95% less radiation than CT scans
• Microdose capabilities for long-term monitoring
• Detailed 3D images for surgical planning, if needed

Thanks to support from the Norton Children’s Hospital Foundation and the PACCAR Foundation, this advanced imaging system is available at Norton Children’s Leatherman Spine.

Pediatric Scoliosis Treatment Options

Every child is unique, and our pediatric orthopedic team creates custom treatment plans based on your child’s curve severity and growth stage. Treatment options include:

• Observation for mild curves that don’t require intervention
• Bracing to prevent further curve progression
• Scoliosis surgery (such as spinal fusion surgery, growing rods, tethering and other growth-friendly options) for severe scoliosis

Without scoliosis care and treatment, complications may develop later in life, including:

• Pain in the neck, back or hips
• Reduced range of motion 
• Changes in physical appearance
• In severe cases, pulmonary, cardiovascular or digestive issues
• Body image issues

Why Choose Norton Children’s Leatherman Spine

• Children need spine care that’s unique to their growing bodies. We use a team approach to diagnose, treat and rehabilitate spine and spinal cord conditions in children.
• As surgeons, our specialists have the experience to know when surgery can help your child and when more conservative treatments, such as physical therapy and bracing, can help. Most of our patients don’t need surgery.
• Locations in Hikes Point and downtown Louisville are staffed by five physicians and three physician assistants.
• The EOS Imaging system uses extremely low-dose radiation for monitoring spinal conditions, including scoliosis, kyphosis and deformities.
• We’re home to the world’s first implantation of VerteGlide, a system of straightening rods that moves with your child’s growth, reducing the need for follow-up surgical adjustments.
• Our physicians are internationally recognized leaders in clinical research of spinal disease, injury and deformity, opioid management, spine surgical innovations, scoliosis and more.
• Recognized for expertise in pediatric orthopedics by U.S. News & World Report.
• Several of our providers are leaders in the Scoliosis Research Society, the most prestigious organization for scoliosis surgeons around the world.
• Norton Children’s Hospital is verified as a Level I Children’s Surgery Center by the American College of Surgeons Children’s Surgery Verification (ACS CSV) Quality Improvement Program.
• Medicaid and most major commercial insurance are accepted. Financial assistance also is available.
• Use your free Norton MyChart account to communicate with your provider, manage appointments, refill prescriptions and more.