Scoliosis in children/adolescents – Guidance for parents
Scoliosis is a sideways curvature of the spine. Adolescent idiopathic scoliosis is the most common spinal condition in children, and is usually diagnosed between the ages of 10 and 18. ”Idiopathic” means that the exact cause of the condition is unknown, but genetic factors and growth play a role.
1. How is scoliosis diagnosed?
The majority of cases are found during school health check-ups. In the early stages, scoliosis is often completely painless and asymptomatic, which is why regular screenings are important.
Forward Bending Test: The child bends forward with his legs straight. The health care provider measures possible asymmetry of the back (side hump) with a scoliometer.
X-ray: If the screening result exceeds the cut-off values, the child is sent to a doctor and a standing X-ray of the back is taken. A diagnosis of scoliosis is made if the curvature of the back (the so-called Cobb angle) is more than 10 degrees.
2. Monitoring and treatment goals
The goal of treatment is to prevent the curvature of the spine from worsening during growth. If scoliosis remains below 30 degrees at the end of growth, the risk of back health later is the same as in the general population.
Mild scoliosis (10–25 degrees): Regular follow-up (usually every 6–9 months) with X-rays and clinical examinations. The majority do not require any further treatment.
3. Corset treatment
Brace treatment is considered when the child still has some growth left and the scoliosis is 25–40 degrees. The goal of the brace is to support the back and prevent the curvature from progressing to the surgical limit.
Boston corset: Used as much as possible (target 23 hours a day).
Providence night corset: Used only at night.
The key to success: The effectiveness of corset therapy is based on how regularly the child commits to wearing the corset.
4. Surgical treatment
Surgery is usually recommended when scoliosis exceeds 45 degrees. The reason is that curves over 40–45 degrees often continue to progress slowly even after growth has stopped.
Ossification surgery: The spine is straightened and supported with titanium screws and rods. The procedure corrects most of the curvature and improves the position of the chest.
Why is surgery important? Very severe scoliosis (over 60 degrees) can limit lung function and later cause significant back pain and decreased functional capacity.
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