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Scoliosis can occur before age 10, but it's rare and is often caused by a condition such as a spinal tumor, congenital heart disease, or a genetic disorder. Scoliosis that appears before the teen years may need many tests to make the diagnosis. The most common form of scoliosis is idiopathic, meaning it has no known cause. This form occurs during puberty and is relatively easy to diagnose. Only a small portion of cases need a lot of treatment. Mild idiopathic scoliosis occurs in about 1 in 50 to 1 in 25 teens. More severe curvature occurs much less often.

In most cases, the cause of scoliosis is unknown. This is called idiopathic scoliosis.

Structural scoliosis can be caused by:

• Nervous system diseases such as cerebral palsy, poliomyelitis, or muscular dystrophy
• Birth defects such as hemivertebra, in which one side of a vertebra fails to form normally before birth
• Injury
• Certain infections
• Tumors such as those caused by neurofibromatosis, a birth defect sometimes linked to benign tumors on the spinal column)
• Metabolic diseases
• Connective tissue disorders
• Rheumatic diseases
• Unknown factors (idiopathic scoliosis)

Curves less than or equal to 10° are common and do not need follow-up other than routine screening at well-child visits. Some curves from 11° to 19° need observation. Curves that are 20° or greater need treatment. Treatment may involve anything from close observation to bracing and even surgery, depending on the age of the person and the location of the curve. The decision for bracing or surgery are best made by an orthopedic surgeon familiar with scoliosis and in agreement with the parents and the teen.

But this depends on how much growth remains for the child.

A child who is still growing and has a curve of more than 25° to 39° will also need to wear a brace. So will a child who is still growing and has a curve of 20 to 29 degrees that's getting worse.

Chiropractic treatment, electric stimulation, nutritional supplements, and exercise have not been shown to stop scoliosis from getting worse.

Exercise does not make scoliosis worse. In fact, it is important for all people, including those with scoliosis, to exercise and stay physically fit. Girls have a higher risk than boys of developing osteoporosis later in life. This is a disorder that results in weak bones that can break easily. The risk for osteoporosis goes down in women who exercise regularly all their lives. Weight-bearing exercise such as walking, running, soccer, and gymnastics increases bone density and helps prevent osteoporosis. For both boys and girls, exercising and taking part in sports also improves their general sense of well-being.

Fusion is the joining of 2 or more vertebrae. Surgeons can choose different ways to straighten the spine and also different implants to keep the spine stable after surgery. Implants are devices that remain in the person after surgery to keep the spine aligned.