Orthopaedic Surgery
Types of Scoliosis
Abnormal curvature of the spine can occur in children in a wide range of ages and through a variety of causes. Therefore, scoliosis has actually been categorized into a number of different types, each with its own clinical characteristics. More importantly, each type of scoliosis is managed, or treated, by orthopaedic surgeons slightly differently than the others, so it is important to classify the distinct conditions in this manner.
Idiopathic ScoliosisThe most common type of scoliosis is idiopathic scoliosis, which means that it occurs without known causes. Because this type of scoliosis can affect children at different ages, it has been further broken down into an even more specific set of conditions. There are therefore three sub-types of idiopathic scoliosis that affect children: infantile, juvenile, and adolescent.
Infantile idiopathic scoliosisInfantile idiopathic scoliosis occurs before the age of 3 and is seen more frequently in boys than girls. Most cases resolve spontaneously, but some may progress to more severe deformity. Treatment may include observation, physical therapy, bracing and, under rare circumstances, surgery. For more in-depth information on infantile scoliosis, click here.
Juvenile idiopathic scoliosisJuvenile idiopathic scoliosis is defined as scoliosis occurring between the ages of 3 and 9. It is found more frequently in girls than boys. The abnormal spinal curvatures in children with juvenile scoliosis are generally at a high risk for progression to more severe curves. They usually require bracing and many will go on to require surgery.
Adolescent idiopathic scoliosisAdolescent idiopathic scoliosis occurs between the age of 10 and young adulthood. This condition, also called AIS, is by far the most common type of scoliosis, as well as the type with the best prognosis. AIS may begin to manifest itself at the initial onset of puberty or become apparent or worsen during an adolescent's growth spurt. Girls, or young women, are at higher risk than boys, or young men. Most children with AIS do not develop worsening curvature, and therefore treatment usually begins only with observation.
Congenital scoliosisWhile most cases of scoliosis are considered 'idiopathic' and occur during childhood without a clear cause, a small number of children develop a lateral curvature of the spine even before birth, during the period of fetal growth in the womb. These cases are referred to as congenital scoliosis, which means that abnormal development is the cause of the condition. Congenital scoliosis occurs when bony portions of the spine fail to form properly or normally separated segments fuse together during fetal development. The defects in the spine can be minor, involving only one segment of the vertebral column, or the condition can involve nearly every level and result in a more severe deformity. Treatment ranges from observation to surgery, depending on the appearance of the spinal curvature.
Neuromuscular scoliosisAnother major type of scoliosis is neuromuscular scoliosis, which means that it is caused by the presence of a neurological or muscular disease, such as cerebral palsy or muscular dystrophy. Because there is such a wide variety of these types of diseases that may cause neuromuscular scoliosis, the clinical presentation and severity of this condition is extremely variable. Unlike the other types of scoliosis described here, treatment of neuromuscular scoliosis is very unpredictable, mostly because the abnormal curves of the spine are also unpredictable.
While there are adults with scoliosis, these are cases that usually begin in childhood or adolescence and persist into adulthood. Adult degenerative scoliosis is a distinct condition that results from wear and tear on the spinal column with disc collapse and actually begins in adulthood. Both entities should be managed by adult spine specialists, and therefore will not be described on this website. For more information about adult spine conditions and possible treatment options, please access the website for the New York-Presbyterian Spine Center: http://www.columbiaortho.org/spine.html.
