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Scoliosis is a deformity of the spine in which the straight spine develops a curve when viewed from behind, which may be very subtle to severe. Scoliosis most commonly occurs in the thoracic area of the spine, but can also occur in the lumbar back. It is usually noted in the early teens but can present at any age, and it is also much more common in girls than boys. Children are screened by their pediatrician and at school for scoliosis and are referred to a specialist for diagnosis if there is any question as to whether they have the condition.
In most teenagers, no cause for the scoliosis is noted and this is called "idiopathic" scoliosis. In adults, the scoliosis may be due to excessive wear and is called "degenerative scoliosis."
Scoliosis in teenagers is usually not associated with pain, and if pain is present further testing is required. Adults do frequently present with pain that may be worse with standing and relieved with rest.
A careful physical examination will detect scoliosis in the majority of teenagers and adults, but an x-ray is usually required to determine the severity of the curve. If pain is present, an MRI of the entire spine may be required.
The treatment of scoliosis in children and teenagers depends on the age of the patient and the degree of the curvature. Curves less than 10 degrees are not even considered scoliosis and no treatment is required. Moderate curves may require a brace, and more severe curves may need surgery. Spinal surgery for scoliosis is done to improve the curve and stop the progression.
Most adults are managed with physical therapy and exercise. However, if the curve is severe and painful then surgery may be indicated.