[KoK! Health] Our Child’s ‘Curved Spine’… Let’s Correct It During Winter Break

When most people hear "spinal disease," they typically think of degenerative conditions such as spinal stenosis or herniated discs, which mainly occur in middle-aged and older adults. However, there are spinal diseases more commonly found in adolescents under the age of 10. One such condition is pediatric scoliosis, where the spine cannot stand straight and curves abnormally to the side.

Forward Bending Test Method to Diagnose Pediatric and Adolescent Scoliosis [Photo by Gangnam Bedro Hospital]

A healthy spine appears as a straight line when viewed from the front, with the head positioned at the center of the body. If the angle of lateral curvature of the spine, known as the "Cobb angle," is 10 degrees or more and there is abnormal rotational change in the spine, scoliosis is diagnosed. About 85-90% of scoliosis patients have idiopathic scoliosis, which occurs without a specific cause. Approximately 1.5-3% of all adolescents suffer from scoliosis. The incidence is 3 to 5 times higher in girls than in boys. Symptoms often become noticeable and are detected around the age of 14, when puberty begins.

Dr. Lee Chun-seong, Director of the Spine Center at Gangnam Bedro Hospital, explains, "Idiopathic scoliosis is a structural deformity unrelated to genetic factors or posture." He adds, "It differs from functional scoliosis caused by heavy backpacks or poor posture, and neuromuscular scoliosis caused by conditions such as cerebral palsy or poliomyelitis."

Idiopathic scoliosis rarely resolves naturally and tends to worsen during growth. However, aside from cosmetic issues such as uneven body shape, there is usually no pain or other abnormal symptoms, making early detection difficult. If left untreated, the curvature of the spine, called 'angulation,' can worsen, increasing the likelihood of asymmetrical body development. This not only causes psychological distress during adolescence but can also lead to lower back pain in middle age and beyond.

Parental attention is crucial for early detection of idiopathic scoliosis by carefully observing the child's body shape and symmetry. Dr. Lee advises, “In scoliosis cases, the heights of both shoulders and pelvis differ, and body balance is disrupted.” He recommends simple tests such as the ‘forward bend test,’ where the child bends forward with knees straight and fingertips touching the floor to check the symmetry of the shoulders, back, and waist.

Lee Chun-sung, Director of the Spine Center at Gangnam Bedro Hospital, is monitoring before surgery for adolescent scoliosis.
[Photo by Gangnam Bedro Hospital]

Treatment depends on the degree of curvature and growth status. If the scoliosis angle is less than 20 degrees or diagnosed before the age of 10, non-surgical treatments such as wearing a brace are applied, with regular monitoring every 4 to 6 months. However, surgery is recommended if the curvature exceeds 45 degrees during growth or 50-55 degrees in adults. Even if there is no immediate discomfort, timely treatment is advised as the curvature may worsen. If the curvature exceeds 70 degrees, it can interfere with daily life and reduce quality of life due to back pain in middle age. Considering spinal flexibility, surgery is ideally performed before the age of 20 to maximize the effectiveness of correction and rehabilitation.

Scoliosis surgery aims to reduce the curvature and restore spinal balance. Most surgeries are performed using a posterior approach from the back of the spine. Postoperative pain lasts for 2 to 3 days but can be effectively managed with painkillers and anesthesia. After a period of rest and recovery, normal activities can be resumed. This is why many adolescent patients prefer to schedule surgery during winter vacation, allowing sufficient recovery time.

Since surgery is performed during growth, concerns about growth cessation or complications during pregnancy and childbirth are common but generally unfounded. The spinal bones reach nearly adult length by around age 10, so surgery to straighten the curved spine may even result in slight height increase. Pregnancy and childbirth pose no significant problems if surgery and recovery proceed well.

Dr. Lee Chun-seong of Gangnam Bedro Hospital’s Spine Center emphasizes, “Early diagnosis and timely treatment of idiopathic scoliosis are crucial.” He advises, “Rather than ignoring symptoms because they are not currently severe, it is best to consult a specialist with extensive experience in scoliosis for thorough evaluation and to decide on appropriate treatment.”

This content was produced with the assistance of AI translation services.