Scoliosis

Scoliosis is a spinal condition characterized by an abnormal curvature of the vertebrae (spinal bones). Although some people do not notice any symptoms, others experience chronic pain and mobility issues.

Various treatments, including physical therapy, bracing, and surgery, can help people with scoliosis lead healthy and pain-free lives.

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On this page

• What Is Scoliosis?
• What Are the Symptoms of Scoliosis?
• How Do You Diagnose Scoliosis?
• How Do You Treat Scoliosis?

What Is Scoliosis?

Scoliosis is a condition that occurs when your spine curves abnormally to the side, forming an "S" or "C" shape rather than a straight line. A normal spine, when viewed from behind, appears straight, whereas scoliosis may cause visible curvature and asymmetry in your rib cage and posture.

Scoliosis can be mild and have little impact on your everyday activities or severe, leading to chronic pain and mobility issues. Monitoring is crucial, especially in children, as the curvature may worsen with growth.

Treatment options range from noninvasive therapies to advanced surgical procedures.

What are the types of scoliosis?

There are different forms of scoliosis, including: 

• Congenital scoliosis — Present at birth due to malformations in vertebral development.
• Degenerative scoliosis — Occurs in adults due to spinal degeneration, arthritis, osteoporosis, or leg length differences.
• Idiopathic scoliosis — Most common, with no known cause. It typically appears during adolescence and is more prevalent in females.
• Neuromuscular scoliosis — Develops as a secondary condition related to neurological disorders such as cerebral palsy or muscular dystrophy.
• Structural and nonstructural scoliosis — Structural scoliosis results from permanent deformities, while nonstructural scoliosis is often temporary and correctable.

Scoliosis severity classification (Cobb method)

The severity of scoliosis is determined using the Cobb method, which categorizes the rotated backbones based on the degree of curvature. Classifications include:

• Mild scoliosis — A curvature of 10 degrees or greater. 
• Significant scoliosis — 25 degrees or greater.
• Severe scoliosis — 45 degrees or greater.

What causes scoliosis?

In most cases, scoliosis is idiopathic, meaning the cause is unknown.

What are the risks and complications of scoliosis?

Scoliosis risk factors

Factors that may contribute to scoliosis include:

• Birth defects such as spina bifida.
• Family history.
• Genetic disorders such as muscular dystrophy.
• Neurological conditions such as cerebral palsy.
• Spinal injuries or infections.

Complications of scoliosis

Severe scoliosis (curvature of more than 60 degrees) can lead to:

• Cardiac and respiratory issues.
• Chronic pain and reduced mobility.
• Psychosocial problems such as body image concerns and emotional distress.

Groups such as the National Scoliosis Foundation (NSF) can provide support and resources.

How can I prevent scoliosis?

The causes of scoliosis are mostly unknown, so scoliosis can’t be prevented. However, you can maintain your spinal health by:

• Avoiding carrying heavy backpacks for prolonged periods.
• Following a nutrient-rich diet to support bone health.
• Getting regular physical checkups to monitor spine development.
• Staying active and engaging in core-strengthening exercises.

How common is scoliosis?

Scoliosis affects about 3 percent of the U.S. population — or around 12 million adults. 

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What Are the Signs and Symptoms of Scoliosis?

Many individuals with scoliosis have no symptoms, but common signs include:

• Back pain (more common in adults).
• Muscle stiffness or radiating pain in your legs and feet.
• Postural imbalance.
• Uneven hips and shoulder blades.
• Visible spinal curvature.

When should I see a doctor about my scoliosis symptoms?

You should see a doctor if:

• You notice signs of scoliosis in yourself or your child.
• You have persistent or worsening back pain.
• Your mobility or breathing is affected.

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How Do You Diagnose Scoliosis?

To diagnose scoliosis, your doctor will first do a physical exam while you are standing and bending forward. This allows them to check for visible curvatures or abnormalities. They may also ask about your family medical history.

Your provider may order imaging tests to better understand the severity of your scoliosis. 

These tests may include:

• Bone scan — Identifies abnormalities using a radioactive tracer.
• CT scan — Creates a 3D image of your spine.
• MRI — Provides detailed imaging of soft tissues and nerves.
• X-ray — Shows the degree of curvature in your spine (most commonly used).

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How Do You Treat Scoliosis?

Scoliosis treatment depends on a few factors, including:

• Age.
• Degree of your curvature.
• Pain associated with the condition.
• Type of scoliosis.

Nonsurgical treatments for scoliosis

Bracing

For people with significant scoliosis (25-40 degrees) who are still growing, a back brace can help prevent further curvature of the spine. Although bracing will not straighten the spine, it can be effective if the condition is caught early. and the brace is worn continually. Doctors typically recommend wearing the brace for 16-23 hours daily until the person stops growing. 

Pain management for scoliosis

There are therapies to help manage scoliosis pain without correcting the issue, including:

• Chiropractic care.
• Hydrotherapy (using water jets to massage painful areas).
• Massage therapy.
• Orthotic insoles.
• Pain injections.
• Pain medications, such as ibuprofen and acetaminophen.
• Physical therapy (strengthening and flexibility exercises).

Surgical treatment for scoliosis

Although most people do not need surgery to correct their scoliosis, it may be an option if:

• Spinal curvature is severe or more than 45 degrees.
• Nerve compression occurs.
• Nonsurgical treatments have not worked.
• Pain is severe and persistent.

Traditional spinal surgery can be a major operation. Modern medical advances have made more minimally invasive treatment options available. 

Traditional surgery for scoliosis

There are two traditional surgery options for people with scoliosis:

• Lumbar decompression surgery — Removes pressure on nerves that may be squeezed or irritated.
• Spinal fusion surgery — Joins two or more vertebrae together with metal rods and screws to help strengthen, stabilize, and straighten your spine.

Minimally invasive surgery for scoliosis: XLIF® (eXtreme lateral interbody fusion)

UPMC surgeons utilize an advanced surgical approach known as XLIF®, or eXtreme lateral interbody fusion, to treat scoliosis. Key benefits of XLIF include:

• Effective for pain relief and spinal stabilization.
• Fewer complications when compared to traditional open surgeries.
• Reduced pain and blood loss.
• Shorter hospital stays.

What does the doctor do during an XLIF procedure?

During XLIF, your neurosurgeon will:

1. Access your spine from the side of your body instead of the front or back, as in traditional open procedures.
2. Perform an initial surgery to decompress your nerve roots and restore flexibility in your spine.
3. Perform a second surgery to correct your spinal alignment using cages and biological agents.
4. Place screws and rods to stabilize your spine.

What are the advantages of XLIF?

Advantages of XLIF include:

• Faster recovery and rehabilitation.
• Improved spinal balance and posture.
• Smaller surgical scars.

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Why Choose UPMC for Scoliosis Care?

UPMC surgeons use the least invasive, most effective approach to treat all types of spinal disorders, including scoliosis. Our team has pioneered XLIF and other innovative approaches to spine surgery using advanced devices and techniques — promoting safer surgeries, improved outcomes, and enhanced quality of life.

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By UPMC Editorial Staff. Last reviewed on 2025-05-16.