What is Scoliosis?
Scoliosis is a sideways curvature of the spine — more than 10 degrees — that can develop in children, adolescents, or adults. On an X-ray, it can look like a single C-shaped curve or a double S-shaped curve, and may develop in the neck, chest, or lower back.
Most people picture scoliosis as a childhood condition, but spinal deformity affects adults too — either as a continuation of a curve from childhood, or as a new "degenerative" curve that develops later in life from age-related wear and tear of the spine.
Types of Spinal Deformity
- Adolescent Idiopathic Scoliosis (AIS) — the most common type, appearing during the adolescent growth spurt, with no single identifiable cause
- Neuromuscular Scoliosis — curves associated with conditions like cerebral palsy or spinal muscular atrophy
- Scoliosis associated with Neurofibromatosis — a genetic condition that can cause more aggressive curve patterns
- Degenerative (Adult) Scoliosis — curves that develop later in life due to disc and joint wear and tear, often alongside spinal stenosis
- Kyphosis — an exaggerated forward rounding of the back
Signs to Look For
- One shoulder higher than the other
- One shoulder blade more prominent than the other
- Uneven waist or hip height
- Trunk shifted to one side
- Clothes hanging unevenly
These signs can be subtle. Many curves are first noticed by a parent, a teacher, or even incidentally on an X-ray taken for an unrelated reason — not because of pain. Scoliosis is rarely painful in its early stages.
How It's Diagnosed
A clinical examination, including the forward-bend test, is usually the first step. A standing, full-length X-ray of the spine confirms the diagnosis and allows the curve to be measured precisely in degrees — the Cobb angle. MRI is reserved for atypical curve patterns or before surgical planning.
Treatment Options
Observation
Most small curves simply need periodic monitoring — an exam and X-ray every 4–12 months — particularly during the adolescent growth spurt, when curves are most likely to progress.
Bracing
For moderate, growing curves, a brace can help control progression until growth is complete.
Surgery
Surgery is considered when a curve is large and likely to keep progressing, or in adults when a curve is causing significant pain, imbalance, or nerve compression. Techniques include posterior spinal fusion with instrumentation, and for severe, rigid deformities, vertebral column resection and pedicle subtraction osteotomy.
Dr. Kshitij Chaudhary trained in complex spinal deformity surgery at Harvard Medical School (Beth Israel Deaconess) and the Twin Cities Spine Center, Minneapolis — among the leading centers for deformity correction worldwide.
Learn More
- Adolescent Idiopathic Scoliosis – A Guide for Parents
- Neuromuscular Scoliosis
- Neurofibromatosis and Scoliosis
- Know about Scoliosis (Video)
Common Questions
Does a heavy school bag cause scoliosis?
No — this is a common myth. Scoliosis is not caused by backpacks, poor posture, or sitting habits.
Will my child's curve definitely get worse?
Not necessarily. Curve behavior depends on size, location, and how much growth remains. Many small curves never progress to need treatment.
Is scoliosis surgery very risky?
Like any major surgery, it carries risks, but with modern techniques and experienced teams, scoliosis correction has a strong safety record and can be transformative for the right patient.
Written by Dr. Kshitij Chaudhary, Spine Surgeon, P.D. Hinduja Hospital, Mumbai. This information is for general education and does not replace a consultation with your doctor.