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Adolescent idiopathic scoliosis
Reviewed by Medicinsk Expert•Last updated: 2026-10-22•Condition

Adolescent idiopathic scoliosis

Adolescent idiopathic scoliosis is a common spinal abnormality characterized by a side-to-side curvature of the spine that develops during the adolescent growth spurt.

Overview

Adolescent idiopathic scoliosis involves a spine that develops an "S" or "C" shaped curvature and slight rotation. It typically appears during rapid growth in late childhood or adolescence. While mild cases are often stable, some curves are progressive and become more severe over time. Severe, progressive curves are more common in girls, though mild curvature is equally common in both sexes.

Symptoms

Mild scoliosis is often painless and may not be noticed until a physical exam or school screening. Common signs include:

  • Asymmetry in the shoulders, hips, or waist
  • One leg appearing longer than the other
  • Visible tilt or curvature of the spine

Causes

The term "idiopathic" indicates that the exact cause is unknown. It is believed to result from a combination of environmental and genetic factors. Researchers suspect that multiple genes are involved, with some contributing to the development of the disorder and others influencing the severity or progression of the spinal curve. Potential factors under study include hormonal issues, abnormal bone or muscle growth, and nervous system abnormalities.

Inheritance

The inheritance pattern is unclear due to the involvement of multiple genetic and environmental factors. The condition can be sporadic (occurring without a family history) or cluster in families. Having a close relative with the condition increases a child's risk of developing adolescent idiopathic scoliosis.

Frequently Asked Questions

Bracing is usually recommended when the Cobb angle is between 25° and 40° and the child is still growing (Risser sign ≤2). The goal is to prevent progression beyond 45°–50°, which often necessitates surgery. Studies show that full‑time wear (≥18 hours/day) of a thoracolumbosacral orthosis can reduce curve progression by 50%–70% compared with observation alone, provided the teen adheres to the schedule.
For curves 40°, every 3–4 months or as directed by the surgeon. Modern low‑dose digital radiography and the use of a single‑view (standing postero‑anterior) reduce exposure to less than 0.1 mSv per study—about the same as a few days of natural background radiation.
Evidence‑based physiotherapeutic scoliosis-specific exercises (PSSE), such as the Schroth method, focus on three‑dimensional postural correction, breathing techniques, and muscular symmetry. When performed 3–5 times per week under a certified therapist, PSSE can improve trunk balance and may modestly reduce curve progression, especially in curves <30°. However, exercises alone are not a substitute for bracing when indicated.
Untreated moderate curves can continue to progress after growth stops, leading to cosmetic concerns, chronic back pain, and, in severe cases, reduced pulmonary function if the thoracic cage is deformed. Degenerative changes in the vertebrae and discs may appear earlier, and the risk of needing surgical correction later in life increases. Early monitoring and appropriate intervention can mitigate these outcomes.
Source: MedlinePlus, National Library of Medicine

MedlinePlus brings together authoritative health information from the National Library of Medicine (NLM), the National Institutes of Health (NIH), and other government agencies and health-related organizations.

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