WHAT YOU NEED TO KNOW:

What is scoliosis? Scoliosis is an abnormal curving of the spine. Scoliosis can develop at any age in children, but often starts during adolescence.

What increases the risk of scoliosis? In most cases, the cause of scoliosis is not known. The following may increase your child's risk of scoliosis:

• He was born with a birth defect that increases the risk of scoliosis.
  
  
• He has a family member with scoliosis, especially if both parents had scoliosis.
  
  
• He had a fracture (broken bone), radiation, or surgery involving the spine.
  
  
• He has a disease that causes problems in muscle control or activity. Examples are polio, cerebral palsy, and muscular dystrophy. Ehlers-Danlos, Marfan syndrome, and osteogenesis imperfecta (brittle bone disease) may also increase the risk.

What are the signs and symptoms of scoliosis?

• Leaning to one side when standing, sitting, or walking
  
  
• One shoulder blade, set of ribs, or hip that sticks out more on one side than the other
  
  
• Shoulder or waist that is higher on one side than the other
  
  
• Sunken chest, rounded shoulders, and swayback
  
  
• Trouble breathing or back pain if scoliosis is severe

How is scoliosis diagnosed? Your child's healthcare provider will ask if your child has any other health conditions. He may ask about his growth and development, and if he has had any surgeries. He will examine your child and ask him to bend forward. He will also check your child's shoulders, hips, legs, and ribs. Your child may also need the following tests:

• X-rays: Healthcare providers use these pictures to check the curve and shape of your child's spine. X-rays may show if there are other conditions, such as broken, incomplete, or fused bones. They may also show if your child is still growing.
  
  
• CT scan: This test is also called a CAT scan. An x-ray machine uses a computer to take pictures of your child's spine. Your child may be given dye before the pictures are taken to help healthcare providers see the pictures better. Tell the healthcare provider if your child has ever had an allergic reaction to contrast dye.
  
  
• MRI: This scan uses powerful magnets and a computer to take pictures of your child's spine. Your child may be given dye to help the pictures show up better. Tell the healthcare provider if your child has ever had an allergic reaction to contrast dye. Do not let your child enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if your child has any metal in or on his body.

How is scoliosis treated? The goal of treatment is to correct or control the curving of the spine and prevent further problems. Treatment may depend on when the condition started and the severity of your child's symptoms. If the curve is mild or your child is almost fully grown, his healthcare provider may recommend regular visits to monitor the scoliosis. Your child may need any of the following:

• Cast or brace: This may help keep your child's spine from curving or stop the curving from getting worse. Most braces are small and light and may be worn under clothes. Sometimes a cast is used first and replaced with a brace after a few months. The brace may be adjusted as your child grows.
  
  
• Surgery: Your child may need surgery if the curve is severe and a brace has not helped. Healthcare providers may place rods, screws, or wires to help straighten the spine.

What are the risks of scoliosis? Treatments for scoliosis, such as a back brace, may be very uncomfortable for your child. Your child may bleed more than expected during surgery. He may also get an infection or have an injury to his spinal cord. If left untreated, the curve of his spine may get worse. This may decrease the space in your child's chest for his heart and lungs to work correctly. His spinal cord and nerves may get pressed on and lead to problems or changes in organ function.

When should I contact my child's healthcare provider?

• Your child has a fever.
  
  
• You have questions or concerns about your child's condition or care.

When should I seek immediate care or call 911?

• Your child has back pain that is worse or does not go away after he takes pain medicine.
  
  
• Your child has problems urinating or having bowel movements.
  
  
• Your child has shortness of breath, coughing, wheezing, or noisy breathing.
  
  
• Your child has trouble moving his legs.
  
  
• Your child's legs are numb, weak, or he cannot feel them.

CARE AGREEMENT:

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child.