To book an appointment with a spinal consultant specialising in scoliosis please call 

What is scoliosis and whom does it affect?

Scoliosis is a condition that causes the spine to curve or twist abnormally to the side. It usually develops during childhood or adolescence, often starting between the ages of 10 and 15. In the UK, three to four in every 1000 children need treatment for the condition. It can also affect adults, typically when scoliosis is not detected during childhood, the condition progressing gradually with the effect of gravity by 1-2 degrees per year to a point where the spine becomes imbalanced and surgery may be indicated. Adults may also develop scoliosis in association with severe degeneration affecting multiple levels, typically in the lumbar spine.

The incidence of scoliosis is equal amongst girls and boys. However, teenage girls are three times more likely to require surgery; in children under the age of 10 years, boys have a much higher risk of requiring surgery.

Is scoliosis hereditary?

Idiopathic scoliosis is now identified as a genetic condition, however the hereditary nature of it remains unclear.

What are the signs and symptoms of scoliosis?

Scoliosis is often noticeable as a spinal imbalance, with sloping shoulders or waist asymmetry.

Signs to look out for include:

  • The upper body leaning to one side or the head being slightly off centre
  • The level of the shoulders being uneven, or one shoulder blade protruding
  • The ribcage not being symmetrical and sticking out on one side
  • Uneven leg length or one hip more prominent from the main frame of the body
  • Clothes being consistently ill-fitting in one area around the body frame
  • Back pain (usually experienced by adults).

If you are concerned that you or a family member may have scoliosis, a specialist assessment is essential. Your GP can refer you to a spinal consultant, specialising in scoliosis.

How is scoliosis diagnosed?

A consultant will undertake a physical examination, looking at posture, the spine, rib placement, hips and shoulder position.

To confirm scoliosis, you will need to undergo an X-ray. This will help determine the shape, direction and angle of the curve and the region of the spine that is affected. In an X-ray viewed from the front or back, a normal spine will appear almost straight, while a spine with scoliosis will curve to the side in an ‘S’ or ‘C’ shape, tending to affect the thoracic (middle) or lumbar (low back) regions.

If symptoms include severe back pain, your consultant may also undertake an MRI or CT to investigate further and to rule out similar conditions such as lordosis or kyphosis.

What treatment is available for scoliosis?

Although most scoliosis curves have little health impact, the condition can occasionally result in progressive curves that are visible and which may cause pain. It is rare for scoliosis curves to affect lung function, but this can be an issue in younger children, under the age of 10 years. Continuing with activities or exercise is usually encouraged. A small number of patients with scoliosis may require surgery.

Scoliosis treatment for children

In children or adolescents mild curves will not usually result in surgery as the curve can correct itself as the child grows, or remain relatively small and balanced. However, the consultant will arrange follow-up consultations (usually every 4 months or so) to observe and monitor the curve of the spine.

In some cases additional X-rays may be required. If moderate scoliosis is present and the bones are still growing, a brace may be recommended. The brace may prevent further curvature to the spine.

Adult and paediatric scoliosis patients can be seen at The Wellington Hospital (children over 3 years and upwards). Paediatric patients can also be seen at The Portland Hospital for Women & Children.

Surgical treatment for scoliosis 

Paediatric patients requiring surgery are operated upon at The Portland Hospital or The Harley Street Clinic. Adult patients (18 years upwards) are operated upon at The Wellington Hospital.

In more severe cases, fusion surgery is an option to reduce the curve of the spine and prevent the condition progressively worsening over time. Surgery is usually only required if the scoliosis is progressive. Pain and cosmesis are also considerations for surgery.

Scoliosis surgery involves multiple vertebrae being corrected with screws and metal rods to hold the spine in the optimal position, before a bone graft is applied to set the spine in the corrected position.

Different types of surgery for scoliosis include:

It is undesirable to fuse the spine in a skeletally immature patient, as this can impair lung development. In such patients, there is the option of inserting rods that can be lengthened as the child grows. Such rods are lengthened by a magnet applied externally to the skin of the back in out-patients, a process that is quick and painless. Once the child has reached an appropriate age, a final instrumented fusion can be undertaken.

What happens after fusion surgery?

It is common for spinal fusion patients to stay in high dependency for one to two nights post-operatively. This enables optimal pain relief, and for close monitoring to reduce the risks of complications.

Your consultant will follow up to check your progress after surgery. A brace may be required to assist the position of the spine during healing. You may need to return to hospital to have rods lengthened as the body grows. In some cases further surgery may be necessary.

Are there any risks involved in surgery for scoliosis?

There are some risks with fusion surgery, and your consultant will talk through these in detail, along with the benefits, and answer any questions you may have.

The risks include:

  • Movement of the screws, rods and hooks, helping to hold the spine in place
  • Pseudarthosis, this is where the bone grafts do not fuse to the spine properly
  • Infection
  • Spinal cord injury. This is the most serious complication. An MRI scan of the spine is routinely performed pre-operatively to ensure spinal cord development is normal, With a normal spinal cord, the risk of spinal cord injury is between 0.2-0.5%. Your Consultant will expand upon the impact of this and the risks in your particular case.

What is the expected recovery time?

The bulk of scoliosis surgery is performed upon fit and healthy teenagers that recover very quickly. After one week in hospital, It is typical for such patients to be fully mobile, have stopped all analgesia, and be ready to return to school six weeks following surgery.

To book an appointment with a spinal consultant specialising in scoliosis please call 

Not what your looking for...

Return to The Spinal Unit