Idiopathic Scoliosis

Idiopathic scoliosis is the most common form of scoliosis and one of the most common types of spinal deformity. Idiopathic scoliosis is a condition that causes the spine to curve to the side. Mild cases that do not cause pain or discomfort require no treatment. However, cases that are moderate to severe require treatment determined on a case by case basis. Idiopathic scoliosis is divided into the following categories based on age of onset:

  • Infantile (0-2 years of age)
  • Juvenile (3-9 years of age)
  • Adolescent (9-16 years of age)

When viewed on an x-ray from the front or rear, a normal spine appears to be straight, but a spine affected by idiopathic scoliosis appears to have an S- or C-shaped curve. Most x-rays done by Dr. Feldman are done with the EOS machine, a specialized full-body, low-dose x-ray, in order to significantly reduce radiation exposure.

Children with mild scoliosis may not exhibit any symptoms. Moderate to severe scoliosis may cause parts of the torso and/or pelvic area to become uneven. For example, one shoulder may be higher than the other or the waist may be uneven.

Diagnosis

The first step in checking for scoliosis is taking a family history to see if other family members have had scoliosis. Next, questions are asked to determine if the scoliosis causes pain, numbness, or tingling. Finally, the child is observed and physically examined. As a part of the exam, children may be made to perform the Adam's forward bend test where they are asked to stand and bend forward while the doctor observes the evenness or unevenness of the shoulders, shoulder blades, and rib cage. X-rays are also taken to confirm diagnosis. 

An MRI (magnetic resonance imaging) may be requested if there has been a rapid progression, if it is on the left side of the chest rather than the right side (atypical), or there is a neurologic deficit, such as abnormal reflexes.

The severity of the scoliosis curve is measured in degrees and based on the ankle of the curve in the spine shown on x-rays:

  • 20 degrees or less is a mild curve
  • 20-40 degrees is a moderate curve
  • 40 degrees or more is a severe curve

There is also a genetic test that utilizes the saliva of a young patient to determine if a mild to moderate case of scoliosis will progress further. While the test has limited use and application, it is sometimes performed to aid in determining a treatment plan.

Patient Case Study: Idiopathic Scoliosis

Next Page: Congenital Scoliosis