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Symptoms of scoliosis
Last reviewed: 06.07.2025
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Idiopathic scoliosis is usually first detected in children aged 6-7 years, which corresponds to the first growth spurt. A child with scoliosis should be examined in a standing position from the front, back and side. When examining a child from the front in a standing position with legs straightened at the hip and knee joints, note the asymmetry of the shoulders, anterior upper pelvic bones, waist triangles formed by the lateral surface of the trunk and the inner surface of the upper limb. When examining from behind, determine the lateral deviation of the line of the spinous processes of the spine from the axial line, as well as the asymmetry of the position of the shoulder blades and other bone landmarks. When the child bends forward, asymmetry in the height of the posterior semicircle of the costal arches in the thoracic region (costal hump or gibbus) is revealed, paravertebral asymmetry is revealed in the form of a muscular ridge on the side of the convexity of the curvature arc in the lumbar region (positive Adams test), caused by pathological rotation of the vertebrae.
Further progression of scoliosis leads to aggravation of the described symptoms, increased pelvic tilt and functional shortening of the leg on the side opposite to the apex of the main curvature arc. There is a violation of the biomechanics of the spine, the shift in the center of gravity causes the child's body to tilt towards the curvature. Increased deformation of the chest due to progressive pathological rotation of the vertebrae creates not only an undesirable cosmetic defect (costal hump), but also causes anatomical and functional changes in the internal organs: a decrease in lung volume, impaired respiratory function, a change in the position of the heart and vascular bundle.
The anatomical and functional disorders of the spine, chest and internal organs that occur in idiopathic scoliosis allow us to speak of scoliotic disease.
If scoliosis is detected, it is necessary to begin active comprehensive conservative treatment until the child's growth is complete. A particularly critical period occurs at the age of 11-13 years, when the second growth spurt occurs, and the spinal deformity can progress rapidly.
With the development of spinal deformation of more than 50°, scoliosis under the influence of gravity and the addition of the degenerative component of the intervertebral discs continues to progress throughout life - a gross deformation of the chest in the form of anterior and posterior costal hump develops. At this point, indications for surgical treatment are determined.
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