The ribs inside the curve scrunch together as those outside the curve spread apart. Why some scoliosis curves worsen and others don't is unknown. The larger the curve and the younger the patient when it's discovered, the greater the chance it will worsen, Yahiro says. Other early warning signs, which might resemble poor posture to an untrained eye, include a hip or shoulder higher than the other, protruding shoulder blade, or tilted head. The American Academy of Orthopaedic Surgeons and the Scoliosis Research Society recommend screening girls at 10 and 12 and boys once at 13 or 14.
Many states have scoliosis screening programs in schools.
Tailored Treatment Decisions about scoliosis treatment depend on the person's age, gender, general health, and potential for growth, as well as severity and location of the curve. For a very mild curve, the doctor may only advise monitoring checkups, with x-rays to detect worsening, every three or four months or maybe once a year. Even moderate curves of 25 to 40 degrees may not warrant treatment, Yahiro says. A severe curve of 40 to 50 degrees or more that's detected early, Yahiro says, would be expected to rapidly get much worse, so he would treat it even more aggressively. Another important factor is the patient's attitude toward treatment.