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Grade 3 spinal scoliosis in adults and children
Last reviewed: 12.07.2025
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Curvature of the spine in the frontal plane with an angle of deviation from the axis in the range from 26 to 50 degrees is diagnosed as scoliosis of the 3rd degree. If the curvature does not exceed 30-35 degrees, it is considered moderate, but the greater the angle of deviation, the more obvious the clinical picture and the more severe the condition of patients. [ 1 ]
Epidemiology
According to statistics, scoliosis affects 2-3% of the population; in 80% of cases it is idiopathic scoliosis, which is diagnosed at the age of 10-18 years. [ 2 ]
Grade 3 scoliosis in adults accounts for no more than 0.2-0.3% of cases of spinal curvature in patients over 25 years of age. [ 3 ], [ 4 ]
Causes third-degree scoliosis
The main causes of scoliosis, including grade 3, are described in detail in the publication - Scoliosis: what causes it and how to recognize it? [ 5 ]
The same article presents risk factors for the development of this pathology, including genetic features of bone growth during the formation of the skeleton and posture disorders in children (especially in the frontal plane).
Scoliosis can be a consequence of intrauterine developmental defects of the musculoskeletal system (skeletal anomalies) and one of the symptoms of a number of congenital syndromes and some diseases accompanied by spinal deformation. [ 6 ]
For more information on what can cause grade 3 scoliosis in children, see the following materials:
- Scoliosis in children
- Congenital scoliosis
In many cases, it is not possible to identify the exact cause of spinal deformity, and then idiopathic scoliosis of the 3rd degree is determined (although there are several versions of possible etiological factors). [ 7 ]
And grade 3 dysplastic scoliosis in children is classified as a hereditary systemic skeletal disease with abnormal formation of vertebral joints in the prenatal period: spondylodysplasia, plastospondyly, wedge-shaped vertebrae (with insufficient height of the anterior part of the vertebral body) or lateral hemivertebra (the presence of half of the vertebral joint - a hemivertebra - due to underdevelopment of one of the two centers of formation of articular cartilage). [ 8 ]
In addition, it is necessary to remember that scoliosis is a progressive disease, and although scoliosis of the 3rd degree is diagnosed much more often in adolescents, severe curvature can also occur in adults. And if it is not a progression of previously undiagnosed idiopathic scoliosis, then in many cases scoliotic deformation after 40 years is caused by degenerative-dystrophic diseases of the spine or neuromuscular diseases, and in older age - by displacement of the lumbar vertebrae. [ 9 ]
Pathogenesis
The most pronounced component of three-dimensional deformation of the spine in scoliosis is the lateral curvature of the spine in the frontal plane with torsion (rotation) of the vertebrae. The pathogenesis of such deformation, and in many cases the reasons for its occurrence, are not completely clear. [ 10 ]
However, researchers associate the mechanism of scoliosis development with pathological structural changes in the vertebrae and the intervertebral discs connecting them, which lead to an increase in the tilt of the vertebral joints; with the peculiarities of the growth of the spinal column in childhood (in which the height of the vertebral bodies increases unevenly); with weakness or fibrous changes in the paravertebral muscles, causing displacement of individual vertebrae, etc. [ 11 ]
Symptoms third-degree scoliosis
At the stage of spinal curvature corresponding to the 3rd degree, the first signs are an increase in the angle by which the spine deviates from the axis (the Cobb angle, determined on an X-ray), up to 26 degrees and more – up to 50 degrees.
In this case, there is significant asymmetry of the shoulder blades, shoulder girdles and shoulder joints; deformation of the chest with limitation of its expansion; disruption of the biomechanics of the spine leading to back pain. The center of gravity of the torso shifts, and it takes an inclined position - towards the arc of curvature, and the tilt of the pelvis leads to the development of the so-called short leg syndrome - on the contralateral side. [ 12 ]
In grade 3 thoracic scoliosis, due to the twisting of the vertebrae and the asymmetry of the pedicles of their arches, the ribs protrude, subsequently forming a costal hump.
More information:
Forms
Based on the localization of curvatures, the following types of scoliosis are determined:
- cervicothoracic scoliosis – curvature at the level of the cervical spine (CIII-CVII) and partially thoracic (TI-TV);
- scoliosis of the thoracic spine (thoracic or thoracic scoliosis) - with curvature at the level of the vertebral joints of the thoracic segment (TI-TXII), which is considered the most common;
- lumbar or lumbar scoliosis of the 3rd degree (frontal deformation of the spine at the level of the lumbar vertebrae LI-LIV);
- thoracolumbar or thoracolumbar scoliosis of the 3rd degree.
And according to the form of deformation, C-shaped and S-shaped scoliosis of the 3rd degree are distinguished. With C-shaped, the curvature of the spinal column is one-sided, and this is either left-sided scoliosis of the 3rd degree, or right-sided. [ 13 ]
In S-shaped scoliosis (thoracic, thoracolumbar or lumbar), the curvature has the form of two oppositely directed arcs.
Complications and consequences
In cervical and cervicothoracic scoliosis of the 3rd degree, the consequences and complications may be in the form of narrowing of the lumen of the artery in the cervical spine, leading to the development of vertebral artery syndrome - with severe headaches and tinnitus, numbness in the occipital region and ataxia (impaired coordination of movements).
With thoracic scoliosis of the 3rd degree and a strong S-shaped curvature of the spine, patients - in addition to chronic pain in the back and thoracic ribs - experience cardiological and pulmonary problems: displacement of the heart (with the risk of its failure) and a decrease in the total capacity of the lungs with pulmonary hypertension and shortness of breath. And if intramedullary compression of the spinal cord occurs with S-shaped scoliosis, paralysis of both legs may occur. [ 14 ]
Consequences of grade 3 dysplastic scoliosis include chest deformation, muscle dystonia, and urinary incontinence.
Children under five years of age with severe congenital scoliosis have an increased risk of developing pulmonary heart disease, and if left untreated, death.
Diagnostics third-degree scoliosis
To prevent scoliosis from progressing to stage 3, the deformity should be detected when the curvature angle is 10 degrees or slightly more. [ 15 ]
Diagnostics includes determining the condition of the spinal column taking into account visual criteria of statics and dynamics of the musculoskeletal system and using various methods of examining the spine.
Radiography in three planes, spondylometry, MRI or computed tomography of the spine [ 16 ] are the main methods by which instrumental diagnostics of scoliosis is carried out. [ 17 ], [ 18 ]
Differential diagnosis
Differential diagnosis is carried out with pathological kyphosis and lordosis.
- Read more – Scoliosis diagnostics
Who to contact?
Treatment third-degree scoliosis
Traditional treatment for a Cobb angle of 26-50 degrees consists of corrective therapy: to correct the abnormal curvature as much as possible and stop the progression of the curvature, a redressing orthosis or a compensating corset is used for grade 3 scoliosis. [ 19 ]
There are various types of corsets for corrective fixation of the spinal column and its stabilization, but one of the most effective over the past 40 years is considered to be the Cheneau corset for scoliosis of the 3rd degree in children and adults. The corset is made individually, taking into account the anatomical features of each patient, using an X-ray with the corresponding measurements of the torso or its 3D scanning. The orthosis corrects the scoliotic arc in three planes at once, which makes it possible to facilitate the respiratory function and avoid muscle atrophy.
Treatment of grade 3 scoliosis is complex and combines: exercise therapy – special exercises for grade 3 scoliosis; for S-shaped scoliosis – gymnastics according to Katharina Schroth (with asymmetric exercises); yoga and therapeutic massage (which helps normalize the tone of the back and lower back muscles); physiotherapy (using electrical myostimulation). Manual therapy can be used to improve the extensibility of muscle tissue and increase the range of motion of the spinal joints. [ 20 ]
Experts recommend swimming for scoliosis of the 3rd degree, which has a positive effect on the entire musculoskeletal system. Orthopedists will tell you which exercises in the pool are best to do, see the publication - Exercises for the back in the pool [ 21 ]
Surgical treatment for scoliosis in many cases allows to correct the deformation of the spinal column by increasing the stability of the vertebral joints. In children, scoliosis with a curvature angle of 45 degrees or more requires surgical intervention. What kind of surgery is necessary for scoliosis of the 3rd degree depends on the type of curvature, and it can be spondylodesis with metal implants, epiphysiospondylodesis, corrective vertebrotomy, etc. [ 22 ] More information in the materials:
What should not be done with grade 3 scoliosis?
Answers from specialists to questions frequently asked by patients or parents of children with this degree of spinal deformity.
- How long can you sit or stand in one position?
No more than 20-25 minutes, after which the body position must be changed.
- Is it possible to carry something in one hand or a bag on the shoulder?
It's better not to do this.
- How to sleep with grade 3 scoliosis?
You should sleep on a semi-hard mattress, ideally an orthopedic one.
- Is it okay to wear high heels?
The heel height should be a maximum of 3-4 cm.
- Is childbirth possible with grade 3 scoliosis?
If a woman with this disease becomes pregnant and manages to maintain the pregnancy until the required term, then delivery is performed by cesarean section.
- What sports are prohibited for scoliosis of the 3rd degree?
Football, all contact and strength sports, track and field, artistic gymnastics, and acrobatics are excluded in case of grade 3 scoliosis.
- Are people with scoliosis called up for military service?
Even with grade 2 scoliosis, conscripts are considered unfit for military service, and grade 3 scoliosis and the army are simply incompatible.
- Scoliosis grade 3 and disability
At this degree of scoliotic deformation, disability is granted.
Prevention
Today, the key to preventing the development of scoliotic spinal deformity is correct posture in children and adolescents, and if it is disturbed, posture correction and physical exercises recommended by vertebrologists are necessary.
Read more – Prevention of posture disorders in school-age children.
Forecast
Since grade 3 scoliosis is a progressive pathology, the prognosis cannot be the same for all patients. [ 23 ] It is very important to stop the increase in the angle of curvature of the spinal column using all available medical methods.