# What Are the Different Degrees of Scoliosis?

[Scoliosis,](/resources/tag/scoliosis) [Awareness,](/resources/tag/awareness) [Curves](/resources/tag/curves) 

**What is Scoliosis?**

*Scoliosis is a condition of side-to-side spinal curves that measure greater than 10º. On an x-ray, the spine of a person with scoliosis looks more like an "S" or a "C" than a straight line. These curves may cause your shoulders or hips to be uneven, depending on where your curves are located in your spine.-* [*Scoliosis Research Society*](https://www.srs.org/patients-and-families/conditions-and-treatments/adolescents)

Image of Moderate Scoliosis X-ray  According to Dr. Mostafa El-Feky et. al., (2020) the Cobb angle is defined as, “the most widely used measurement to quantify the magnitude of spinal deformities, especially in the case of scoliosis, on plain radiographs.” (El-Reky et. al., 2020).

Understanding the Cobb Angle     Cobb Angle   Severity   Typical Recommendation (Growing Child)       <10° < />d>  Spinal asymmetry, not scoliosis   No treatment; reassurance. Follow-up checks periodically.     10°–24°   Mild   Observation every 4–6 months     25°–39°   Moderate   Bracing typically recommended     40°–49°   Moderate–Severe   Bracing; surgery considered     50°+   Severe   Surgical consultation     

**Mild Scoliosis**

Mild scoliosis is defined as having an abnormal spinal curvature with a Cobb angle **between 10 degrees and 24 degrees** *(South Florida Scoliosis Center, 2017)*. Mild scoliosis does not usually present with any physical symptoms, and is normally first observed during a routine physical examination screening for scoliosis which is performed during physical education class, or upon evaluation by a primary care physician.

**Moderate Scoliosis**

Moderate scoliosis is when the abnormal lateral spinal curvature exceeds 25 degrees. Moderate scoliosis is defined as scoliotic curve **between 25 degrees and 39 degrees**. This can be measured on plain radiographs via the Cobb angle. Symptoms associated with moderate scoliosis may include physical discomfort, fatigue with physical activity, and visible asymmetry in the spine, ribs, shoulders, or hips.

**Severe Scoliosis**

Severe scoliosis is defined when the lateral abnormal curvature of the spine measured on plain radiographs via the Cobb angle **exceeds 40 degrees**. When the scoliotic curve is greater than 40 degrees it can result in many physiologic symptoms that include many of the body’s systems. Symptoms may include all of the following which were included in both the mild and moderate forms of scoliosis. However, severe scoliosis may present with more severe symptoms including: more prominent rib hump, increased fatigue with sedentary positions as well as with physical activity, clumsy or prone to falls; increased respiratory effort which includes shortness of breath associated with physical activity; pain especially in the spine and lower back and headaches *(South Florida Scoliosis Center, 2017)*. This is the most severe form of scoliosis and can be detrimental to the health of those who suffer from this disease, if the appropriate intervention is not initiated.

##  FAQ 

- Yes — scoliosis can progress, and the risk is highest during periods of rapid growth, particularly the adolescent growth spurt between ages 10 and 14. Children with **more growth remaining** and **larger initial curves** are at the greatest risk of progression ([Scoliosis Research Society](https://www.srs.org/Files/Patient-Brochures/Patient.Adolescent_Idiopathic_Scoliosis_Handbook_for_Patients.pdf)). For mild curves under 25°, most specialists recommend a follow-up X-ray and exam every **4 to 6 months** during growth. Once your child reaches skeletal maturity (typically a Risser sign of 4 in girls and 5 in boys), the risk of significant progression drops dramatically, and monitoring intervals usually expand to once a year or less. After skeletal maturity, curves under 30° rarely worsen, while curves above 50° may continue to progress about 1° per year into adulthood ([Agency for Healthcare Research and Quality](https://www.ncbi.nlm.nih.gov/books/NBK493369/)).

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