The cause of scoliosis in most cases is not known. Scoliosis typically arises in adolescence and its signs often become more pronounced during puberty when there is rapid growth of the body and the spine. Girls are five to eight times more likely to develop scoliosis and the condition is believed to be hereditary so that a family history of scoliosis increase one’s risk for the disease.
In scoliosis the spine is curved abnormally, from side to side. The condition is fairly easy to diagnose and in many cases treatment is not necessary if the abnormal curve is slight. However, once the curvature of the spine passes a certain point, treatment to stop further curving of the spine is necessary. In cases of moderate curvature, external braces will be used to stop progression of the scoliosis. If bracing does not work or if the scoliosis was not diagnosed properly and the curvature of the spine is already severe at the time of first diagnosis, surgery may be needed to implant metal rods into the back to correct the abnormal curvature of the spine.
Pediatricians typically perform examinations of a child’s spine as part of an annual physical examination so that signs of scoliosis can be detected at the earliest possible time and treatment rendered if necessary before the spine has become severely curved. When scoliosis is suspected, the pediatrician will usually order an x-ray to assess the degree of curvature of the spine. In addition to pediatric exams, scoliosis screening tests are also performed routinely by school nurses.
In our practice we unfortunately see many instances of a physician’s failure to properly diagnose scoliosis. In many cases, the signs of scoliosis were seen, but no x-ray was done to assess the degree of scoliosis and thus no treatment was offered at a time when further curving of the spine could have been prevented. In other cases, the pediatrician recognized the signs of scoliosis, but improperly decided to “watch” the scoliosis instead of making a referral to an orthopedic surgeon.
We recently settled the case of a 13 year old boy whose scoliosis was diagnosed by his pediatrician, but unfortunately the doctor failed to order an x-ray and delayed referring the boy to an orthopedist until the scoliosis was severely advanced (more than 45 degrees of curvature at the time of diagnosis). By that time the scoliosis could not be treated with external braces and surgery was needed to restore the curvature of the boy’s spine through the use of spinal rods implanted into the back.