Scoliosis, an abnormal sideways curvature of the spine, is a condition that parents and individuals should be aware of. While it can occur at any age, scoliosis is most frequently diagnosed during specific periods. Understanding the Average Age Of Scoliosis Diagnosis is crucial for early detection and timely intervention. This article, based on insights from experts at the American Association of Neurological Surgeons (AANS), delves into when scoliosis is typically identified and why age plays a significant role in diagnosis and treatment.
When is Scoliosis Typically Diagnosed?
Scoliosis is most often diagnosed in childhood or early adolescence. The spine naturally curves in the sagittal plane (the curves you see from the side), but scoliosis refers to a curve in the coronal plane (from the front or back). While scoliosis can be present at birth or develop in infancy, the primary age of onset for idiopathic scoliosis, the most common type, is between 10 and 15 years old. This period coincides with puberty and the adolescent growth spurt.
This age range is significant because adolescent idiopathic scoliosis (AIS) accounts for approximately 80% of all scoliosis cases. It affects both genders equally at onset, but females are eight times more likely to have curve progression that requires medical intervention. Congenital scoliosis, present at birth due to vertebral malformations, is often diagnosed at a younger age than AIS because the spinal abnormalities are present from infancy and become noticeable earlier. Neuromuscular scoliosis, associated with conditions like cerebral palsy or muscular dystrophy, can be diagnosed at various ages depending on the underlying condition and its impact on spinal development. Degenerative scoliosis, on the other hand, typically occurs in adults, particularly those over 65, and is linked to aging and spinal degeneration.
Different Types of Scoliosis and Diagnosis Age
To further clarify the age of diagnosis, scoliosis in children is often categorized by age groups:
- Infantile Scoliosis (0-3 years): Diagnosed in infancy.
- Juvenile Scoliosis (3-10 years): Diagnosed in childhood before adolescence.
- Adolescent Scoliosis (11 years and older): Diagnosed during puberty and adolescence, up to skeletal maturity.
Idiopathic scoliosis is the most prevalent type within the adolescent group. Congenital scoliosis is usually detected earlier due to its nature, while neuromuscular scoliosis diagnosis age depends on the progression of the neurological or muscular condition causing it. Degenerative scoliosis is an adult-onset condition, typically diagnosed later in life.
Why is Age of Diagnosis Important?
The age at which scoliosis is diagnosed is a critical factor because it directly influences treatment strategies. Spinal maturity, or whether a patient’s spine is still growing, is a key consideration. In growing children and adolescents, early diagnosis allows for monitoring and intervention during the crucial growth period. Bracing, for instance, is an effective treatment option only for patients who have not yet reached skeletal maturity. It aims to prevent curve progression as the child grows.
For scoliosis diagnosed in adolescents, the risk of curve progression is higher during growth spurts. Therefore, regular check-ups and timely intervention, such as bracing or surgery for more severe cases, are essential to manage the condition effectively and prevent it from worsening into adulthood. In adults, particularly with degenerative scoliosis, the focus shifts to pain management and functional improvement rather than preventing curve progression, as skeletal growth is complete. The age of diagnosis, therefore, dictates the goals of treatment and the available options.
Recognizing Scoliosis Symptoms Across Age Groups
Recognizing potential signs of scoliosis is important at any age, but symptoms may manifest differently across age groups. In children and adolescents, scoliosis may not be painful, making early detection through observation crucial. Parents and caregivers should be aware of the following signs:
- Uneven shoulders, where one shoulder may be higher than the other.
- One or both shoulder blades protruding or sticking out more than usual.
- An uneven waistline, with one hip appearing higher than the other.
- The head not being centered directly above the pelvis.
- Rib cages at different heights.
- Changes in skin appearance over the spine, such as dimples, hairy patches, or color changes.
- The entire body leaning to one side.
The Adam’s Forward Bend Test is a common screening method used in schools and pediatrician offices. During this test, a child bends forward at the waist with feet together and arms hanging freely. From this position, any asymmetry of the trunk or spinal curvature can be visually assessed. While this test is a useful screening tool, it’s not definitive, and radiographic tests are necessary for a confirmed diagnosis.
In adults, symptoms might include back pain, which can be more pronounced in degenerative scoliosis. Pain may be activity-related and gradually worsen. Other symptoms in adults can be similar to those in adolescents, such as uneven shoulders or hips, but may also include fatigue and, in severe cases, nerve-related symptoms like leg pain or numbness.
Diagnostic Methods for Different Age Groups
Diagnosing scoliosis involves a comprehensive approach that may vary slightly depending on the patient’s age and the suspected type of scoliosis. The diagnostic process typically begins with a physical examination, including the Adam’s Forward Bend Test. If scoliosis is suspected, imaging tests are crucial for confirmation and to determine the curve’s severity.
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X-rays: Spinal X-rays are the standard imaging technique to diagnose scoliosis. They allow doctors to measure the Cobb angle, which quantifies the degree of spinal curvature. A Cobb angle greater than 10 degrees is generally considered scoliosis. X-rays help assess the type and severity of the curve and monitor its progression over time.
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CT Scans: Computed Tomography (CT) scans provide detailed cross-sectional images of the spine. While not routinely used for scoliosis diagnosis, CT scans can be helpful in cases of congenital scoliosis to visualize bony abnormalities in detail, or when surgery is being considered.
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MRI Scans: Magnetic Resonance Imaging (MRI) is valuable, especially in younger children and cases of congenital or neuromuscular scoliosis. MRI can visualize the spinal cord and surrounding soft tissues, helping to rule out underlying conditions like spinal cord abnormalities, tumors, or tethered cord, which can be associated with scoliosis.
In children, particularly those with congenital scoliosis, it is important to evaluate for other associated congenital abnormalities, especially of the spinal cord, genitourinary system, and heart. Therefore, a comprehensive diagnostic approach may include evaluations beyond just spinal imaging.
What to Do If You Suspect Scoliosis
If you observe any signs or symptoms of scoliosis in yourself or your child, it is essential to seek medical advice promptly. Early consultation with a pediatrician or family doctor is the first step. They can perform an initial screening and, if necessary, refer you to a specialist, such as an orthopedic surgeon or neurosurgeon specializing in spinal disorders. Early diagnosis and management are key to achieving the best possible outcomes for scoliosis. Regular check-ups are particularly important during adolescence, the peak age for scoliosis diagnosis, to monitor spinal health and address any concerns promptly.
Conclusion
The average age of scoliosis diagnosis falls predominantly within adolescence, between 10 and 15 years old, largely due to the prevalence of adolescent idiopathic scoliosis. However, scoliosis can occur at any age, from infancy to adulthood, with different types manifesting at different times of life. Understanding the typical age of diagnosis, recognizing the signs, and seeking timely medical evaluation are crucial steps in managing scoliosis effectively. Early detection, especially during childhood and adolescence, allows for monitoring and interventions like bracing to prevent curve progression and improve long-term spinal health. For adults, diagnosis may focus on managing pain and improving function. Regardless of age, awareness and proactive healthcare are vital in addressing scoliosis and ensuring the best possible quality of life.
Note from AANS
The AANS does not endorse any treatments, procedures, products or physicians referenced in these patient fact sheets. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific neurosurgical advice or assistance should consult his or her neurosurgeon, or locate one in your area through the AANS’ Find a Board-certified Neurosurgeon online tool.
