Scoliosis

Scoliosis is a sideways curve of the spine. Mild scoliosis is common and often harmless; moderate or severe scoliosis can affect posture, function, and (in extreme cases) breathing. Most childhood/adolescent scoliosis has no known cause (idiopathic) and is picked up during growth.

When to screen

• Adolescent growth spurt (10-15 years) — shoulders uneven, one shoulder blade sticking out more, waistline uneven, lean to one side, lump on the back visible when bending forward.
• Adam's forward-bend test — look from behind as the child bends forward with hands together; asymmetry of the back surface suggests scoliosis.
• New-onset back deformity or pain in an adult — evaluate.
• Children with neuromuscular conditions (cerebral palsy, muscular dystrophy, spina bifida) need regular spine assessment.

Evaluation and treatment

• X-ray measures the curve (Cobb angle).
• Mild (<20°) — observation; regular check-up during growth.
• Moderate (20-40°) during growth — bracing (Milwaukee, Boston) — prevents progression in a good share of cases.
• Severe (>45-50°) — surgical correction; specialist spine surgery at experienced centres. Outcomes at Indian paediatric/spine orthopaedic centres are good.
• Physiotherapy — specific scoliosis exercises (Schroth, SEAS) complement other treatment; widely available.
• Congenital scoliosis (from vertebral malformations) and neuromuscular scoliosis — specialised care from early childhood.

Adult scoliosis

• Adult-onset — often degenerative, with back pain and nerve symptoms.
• Treatment: posture, physio, injections, selective surgery.
• Long-standing childhood curves may stabilise in adulthood but can progress.

School screening programmes catch scoliosis early; parents can do the forward-bend test at home occasionally during adolescence. The window for bracing closes quickly once growth completes — don't delay evaluation if a curve is noticed.