Types of Scoliosis

Scoliosis Classification

Scoliosis is not a disease, it is a term used to describe any abnormal, lateral (sideways) curvature of the spine. Viewed from the back, a typical spine is straight. If the spine curves, it can show up as a curve to either side; as a single curve shaped like the letter C or “c-shaped scoliosis” or as a double curve shaped like the letter S or “s-shaped scoliosis”… rarely the curve can be a triple.

thoracic scoliosis_lumbar Scoliosis

Curves are classified by many different components such as their location in the spine. They can occur in the upper back (cervical spine scoliosis), in the middle back (thoracic spine scoliosis) and in the lower back (lumbar spine scoliosis) in various combinations. A lumbar curve typically involves a left convex scoliosis in the lumbar spine that affects an average of 5 vertebrae. Thoracolumbar scoliosis is curvature that includes vertebrae in both the lower thoracic and upper lumbar portion of the spine. Curves can also be defined as left thoracic scoliosis or right thoracic scoliosis. To jump to a section, please use the table of contents below.

Dextroscoliosisscoliosis classification
Levoscoliosis
Kyphosis
Kyphoscoliosis
Lordosis
Idiopathic Scoliosis
Infantile Scoliosis
Juvenile Scoliosis
Adolescent Scoliosis
Adult Scoliosis
Structural Scoliosis
Functional Scoliosis
Neuromuscular Scoliosis
Compensatory Scoliosis

Dextroscoliosis: when viewed from behind, a spinal curve to the right is called Dextroscoliosis (“dextro” means right). Usually occurring in the thoracic spine, or a “Thoracic Dextroscoliosis”, and sometimes the lumbar spine, or a “Lumbar Dextroscoliosis”. It is the most common type of curve and can be seen it can be seen in both children and adults. It can occur on its own (forming a c-curve) or with another curve bending the opposite way in the lower spine (forming an s-curve). The reason dextro is most common is that the body instinctively avoids the heart which is located to the left of the midline of the torso.

Levoscoliosis: when viewed from behind, a spinal curve to the left is called levoscoliosis (“levo” means left). Levoscoliosis is common in the lumbar spine, or a “Lumbar Levoscoliosis”.  The rare occurrence of levoscoliosis in the thoracic spine, or a “Thoracic Levoscoliosis”, indicates a higher probability that the scoliosis may be secondary to a some kind of pathology, such as a spinal cord tumor or chiari syndrome and may affect heart and lung function due to the direction of the curve. Spinal injuries or degenerative conditions such as arthritis and osteoporosis can also cause a levoscoliosis.

kyphoscoliosis

Kyphosis: A curve seen from the side in which the spine is bent forward. There is a normal kyphosis in the middle (thoracic) spine.

Kyphoscoliosis: The abnormal curvature of the spine, both sideways and towards the upper lordosis_lumbar scoliosisback.

Read more about Kyphosis >

Lordosis: A curve seen from the side in which the spine is bent backward. There is a normal lordosis in the upper (cervical) spine and the lower (lumbar) spine.

Read more about Lordosis >

Idiopathic Scoliosis Classification

Idiopathic scoliosis: Occurs in approximately 4% the population. The term idiopathic means a condition or disease with no known cause. Idiopathic scoliosis is by far the most common cause of scoliosis. Idiopathic scoliosis rarely causes pain. Once scoliosis is detected it should be closely monitored by a scoliosis professional. That expert will initiate a proactive plan to ensure the curve does not progress, and if possible will be reduced and stabilized. Active exercise therapy is the current best approach.

Types of Idiopathic scoliosis

Infantile Idiopathic Scoliosis

Infantile scoliosis is defined as scoliosis that is first diagnosed in a child between birth and 3 years of age. 80% of scoliosis in infants will resolve without treatment. Those that do not resolve can be difficult to manage. Frequent checkups are needed and if progression is seen, aggressive non-surgical treatment must be started. There is currently a variety of invasive surgical methods such as stapling or the insertion of expandable rods used for treating infantile scoliosis.

Juvenile Idiopathic Scoliosis

Juvenile onset scoliosis is defined as spinal curves diagnosed between ages 3-10. It is less common than adolescent scoliosis but still makes up one-fifth of scoliosis cases.

Adolescent Idiopathic Scoliosis

Adolescent idiopathic scoliosis occurs in children age 10 to 18 years, and comprises approximately 80% of all cases of idiopathic scoliosis. This age range is when rapid growth typically occurs, which is why the detection of a curve at this stage should be monitored closely for progression as the child’s skeleton develops.

Adult Idiopathic Scoliosis

Once skeletal maturity is reached, a patient with adolescent idiopathic scoliosis is now said to have adult idiopathic scoliosis. A patient with Adult Idiopathic Scoliosis will greatly benefit from treatment for progression. Pain is a common reason for treatment. Normal degenerative changes of the spine may be accelerated by curvature and the patient may be at higher risk for skeletal pain or extremity pain due to nerve compression.

Adult Scoliosis

Not to be confused with adult idiopathic scoliosis, Adult Scoliosis or Adult Onset Scoliosis is a Degenerative scoliosis, or a side-to-side curvature of the spine caused by degeneration of the facet joints. Degenerative scoliosis occurs in older adults, most frequently in people over age 65. Typically a C-shaped curve forms in the lumbar spine. It can occur due to arthritis in the spine, Spondylosis. Weakening of the normal ligaments and other soft tissues of the spine combined with abnormal bone spurs can lead to an abnormal curvature of the spine. The spine can also be affected by osteoporosis, vertebral compression fractures, and disc degeneration. This pain causes people to lean to one side to reduce pressure causing spinal deformity. Degenerative scoliosis is the most common form of scoliosis in adults.

Other types of Scoliosis Classification

Structural scoliosis: Is a fixed curve treated case by case. If the curve is present at birth, it is called Congenital Scoliosis. Structural scoliosis can be cause by birth defects (such as hemivertebra, in which one side of a vertebra fails to form normally before birth). It can also be the result of injury, certain infections, tumors (such as those caused by neurofibromatosis, a birth defect sometimes associated with benign tumors on the spinal column), metabolic diseases, connective tissue disorders, rheumatic diseases. In other cases, it occurs by itself or by unknown factors (idiopathic scoliosis). Structural scoliosis can also be caused by neuromuscular diseases.

Neuromuscular scoliosis: Is associated with a neuromuscular condition or a problem when the bones of the spine are formed. The vertebrae can fail to form completely or fail to separate from each other during fetal development. This type of scoliosis develops in people with other disorders, (i.e. birth defects, muscular dystrophy, cerebral palsy, or Marfan’s disease). People with these conditions often develop a long C curve and their muscles are unable to hold their spine straight.

Nonstructural (Functional) scoliosis: Nonstructural scoliosis is a curve in the spine, without rotation, that is reversible because it is caused by a condition such as: pain or a muscle spasm or a difference in leg length. In this type of scoliosis the spine is normal, but an abnormal curve develops because of a problem somewhere else in the body.

Compensatory scoliosis: A spinal curve in the coronal plane which disappears when the patient sits. It may be caused by either a short leg or a pelvic tilt due to contracture of the hip. This type of curve will straighten significantly on side-bending to produce spinal balance. There may be no underlying structural abnormality.

The location of the structural curve determines the classification of the scoliosis e.g. a structural curve in the thoracic spine with a lumbar compensatory curve is called thoracic adolescent idiopathic scoliosis. Single curves, curves whose apex is at T12 or L1 may be defined as a Thoracolumbar curve , and curves with apices at L2 or L3 are defined as lumbar curves. Structural curves in both the thoracic and lumbar spine are called double major curves. The exact definition of the curve has implications for determining scoliosis progression and scoliosis treatment.

thoracolumbar scoliosis

This is an explanation of just a few basic terms used to classify scoliosis. If it appears complicated, it is. Don’t make the mistake of assuming you have enough understanding to self-diagnose. There are even more complicated classifications for scoliosis such as the King and Lenke Classification systems. It’s always best to consult your physician with any questions you may have about your scoliosis diagnosis.

Posted in About Scoliosis
14 comments on “Types of Scoliosis
  1. Pamela Smith says:

    This is most informative & greatly appreciated.

    • Dr. Andrew Strauss says:

      Thanks for the feedback. We are putting a lot of energy into this site and it is great to hear from the people benefiting!
      Best regards,

      Dr. Strauss

  2. Ann McCabe says:

    This is the most informative scoliosis website that I have seen yet. While it didn’t answer everything I wanted to know as it applies to me, it is by far the best & one that I would recommend to anyone with questions about this condition.

    • Dr. Andrew Strauss says:

      Thanks for the feedback. Our goal is be a resource on all things to do with conservative scoliosis treatment. Please continue to check in on the site because we are writing new articles, posting new finds from around the web, and sharing results of our patients every week!

  3. Madhu says:

    I am 39 yrs,male,single in palakkad,kerala and suffering from right thoraco lumbar scoliosis with great difficulty while sitting/standing and sleeping right side.my right shoulder is up and down right abdomen is inside.severe back pain and also head is slanting towards right.Balancing is difficult and nausea is common.
    please help me by giving me information on its treatment and further damage and pain relief and abnormality structure.

  4. Reynaldo P. Crespo says:

    hello sir..i want to ask something?
    sir in my medical result the radiologist mark my xray as incidental dextroscoliosis thoracic spine.
    I

  5. Peggy Heinsohn says:

    my 8 year old son was diagnoised today with Levoconvexity of the thoracic spine. thats a mouth full to me. so like most parents you hang up the phone or walk out of the doctors office thinking what the hell is that, whats he talking about…..and then jump on the internet. which is what i did. this is the first site i went to that explained in simple terms what im facing along with my son. thank you.

  6. Donna Coltharp says:

    Is an “S-curve” more serious than a single curve? We have a son who was just diagnosed with an “s-curve.” Both are about 20 percent. The advice is wait and re-check, which seems right, but I don’t know if I should be more concerned, given that there are two curves. He has had one incidence of back pain, which is what led to the diagnosis, but I can’t be sure that the pain was caused by the scoliosis.

    • Yes, a double curve (the “S” curve) is typically more challenging to treat. Here we use an exercise based treatment program rather than take a wait and see approach. The problem with the wait and see approach is that if the curve is progressive, the patient has lost the opportunity to treat a smaller curve and any treatment will need to be much more aggressive (whether it is surgery, bracing or exercise based)
      Over 90% of children with AIS have no pain. Contrast this with a 57% incidence of occasional back pain among adolescents and it is likely that your son’s back pain is unrelated to his scoliosis.

  7. Lenore says:

    Hi I’m a 44 year old female with a 46 degree left thoracic curve and 39 degree right lumbar so an extreme s shape. Just recently I’ve been experiencing a racing heart, and difficulty getting good breaths. Is there any hope for me this late in life?? Can I still be braced?? Is surgery an option?

    • Hi Lenore,

      There is always hope!
      I suggest you have a lung function test to begin your investigations.
      It is more typical that the lung and heart issues you are experiencing come with a curve above 70 degrees, but I do see it in smaller size curves like yours in some cases.
      Bracing in adults is an option in selected cases of pain or strong postural shift, but will not address the heart/lung issues.
      The best treatment for your lungs will be revealed by the results of the lung function testing.
      Surgery in adults is a very invasive procedure and best avoided unless truly necessary. (Very strong pain, loss of bowel function, weakness of a limb). Surgery will not address lung issues in an adult, and may even make them worse due to possible complications from the surgery.

      all best with your quest for health,

      Dr Strauss

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