Scoliosis check-ups

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Scoliosis may continue to get worse until the bones stop growing. So it's important to have regular check-ups in the meantime. It is a good idea to only have as many x-rays as really necessary.

Check-ups are done to see

  • whether the curve in the spine has got worse,
  • if treatment (such as a back brace) is having the desired effect, and
  • whether the treatment needs to be changed.

The check-ups are also a good opportunity to discuss any problems you’re having due to the disease or the treatment.

How often are check-ups needed?

How often you need a check-up depends on the severity of the scoliosis and how far your bones have developed overall (your skeletal maturity). Medical societies recommend having a check-up every four to six months.

Skeletal maturity is divided into stages known as “Risser stages,” on a scale of 0 to 5. Risser stages 0 to 2 mean that the bones are still very much in the growth phase. Bone growth is said to be complete at Risser stage 4 for girls and Risser stage 5 for boys. After that, there’s usually no need for more check-ups.

But some experts recommend that people with a “Cobb angle” between 20 and 40 degrees should have one extra check-up around two to four years after they’ve stopped growing. The Cobb angle is a measure of the curve in the spine.

People with severe scoliosis (a Cobb angle between 40 and 50 degrees) are sometimes advised to have check-ups every one to two years after their bones have stopped growing. Surgery may be considered here, too.

Illustration: How the Cobb angle is measured

When are x-rays needed?

X-ray images of the spine are sometimes needed – but not at every single check-up. They are needed in order to

  • provide an accurate if someone is thought to have scoliosis,
  • assess the extent of the curvature and then plan treatment,
  • make sure the back brace fits properly (this involves having an x-ray done while wearing the brace),
  • see whether the scoliosis is getting worse,
  • assess skeletal (bone) maturity or
  • plan surgery, and then later see the results of surgery.

How much radiation are you exposed to?

X-ray examinations always involve exposure to a small amount of radiation. The level of exposure during an x-ray examination of the spine is roughly the same as the natural radiation a person is exposed to during the course of one month. This additional exposure only increases the risk of cancer very slightly.

But it’s still a good idea to avoid any unnecessary exposure to radiation. So you should only have as many x-ray examinations as really necessary.

How can you minimize radiation exposure?

There is no need to do an x-ray at every scoliosis check-up. Often, a physical examination and measurement using a special type of spirit level (a “scoliometer”) are enough. If there is reason to believe that the scoliosis might be getting worse, an x-ray examination can be useful.

If scoliosis is diagnosed and treated while you’re still growing, your spine should be x-rayed every 6 to 12 months until you stop growing. If the scoliosis is stable, the international scoliosis society recommends having x-rays done only every 12 to 18 months.

The spine doesn’t need to be x-rayed from all sides, either. Just one x-ray image from behind is enough to assess the curve properly. This also has the advantage that it doesn’t need as much radiation as an image taken from the front or the side.

Good to know:

Keeping a record of any x-rays you’ve had can help make sure nothing gets done twice. In Germany, you can get an x-ray record card (Röntgenpass) from the Federal Office for Radiation Protection (Bundesamt für Strahlenschutz). Many health insurers supply them too.

Computed tomography (CT) scans aren't needed in order to assess scoliosis. They shouldn't be used for this purpose because the radiation exposure is much higher than from a standard x-ray examination.

Are there alternatives to x-ray examinations?

There is a radiation-free alternative to x-raying, known as video raster stereography. It involves projecting a grid of lines onto your back and recording an image with a camera. The lines are used to produce an image of your back on a computer.

Video raster stereography could possibly be used to replace at least some of the x-ray examinations for scoliosis, but there’s not enough research here to support this approach. In Germany, statutory health insurers do not fully reimburse it.

Deutsche Wirbelsäulengesellschaft (DWG), Vereinigung für Kinderorthopädie (VKO), Deutsche Gesellschaft für Orthopädie und Unfallchirurgie (DGOU). Adoleszente Idiopathische Skoliose (S2k-Leitlinie). AWMF-Registernr.: 151-002. 2023.

Institute for Quality and Efficiency in Health Care (IQWiG, Germany). Idiopathische Skoliose. Kann eine Videorasterstereographie eine radiologische Untersuchung in der Nachsorge ersetzen? Health Technology Assessment im Auftrag des IQWiG: HT17-04. 2019.

Knott P, Pappo E, Cameron M et al. SOSORT 2012 consensus paper: reducing x-ray exposure in pediatric patients with scoliosis. Scoliosis 2014; 9: 4.

IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

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Updated on March 25, 2024

Next planned update: 2027


Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

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