The pubertal growth spurt: why is it the main risk for scoliosis?

Scoliosis is known to be a condition that evolves with growth, the latter being a process that starts on the day we are born and ends when we achieve complete bone maturation (that is to say, at between 16 and 18 years of age, depending on our sex as well as various other subjective factors).
Over this long period of time, however, there are some phases in which the rate of growth speeds up, and these are the times when scoliosis is most at risk of worsening.

One of these phases is the “pubertal growth spurt”, a period of marked and rapid physical transformation that starts with the onset of puberty.

In females, the pubertal growth spurt usually starts at the age of around 11-12 years, as opposed to 13-14 years in males.

In this phase, their growth surges, even to the point of becoming twice as fast as before: whereas youngsters grow at a rate of 5-6 cm each year prior to puberty, during the pubertal growth spurt, they can grow by as much as 10-12 cm per year.

The main difference between these two phases is that prepubertal growth mainly involves the lower limbs, whereas in puberty the extra centimetres gained in height are almost entirely attributable to trunk growth. Therefore, in individuals who already have trunk asymmetries or mild curves, this period demands the utmost vigilance, as the situation can worsen very rapidly.

It is worth pointing out that we are talking about young adolescents, who look after their own personal hygiene and will often tend to close the bathroom or bedroom door when they are showering or getting dressed.
This means that parents, however attentive, may only get the chance to really observe their kids’ backs in the summer months, when they are at the sea or swimming pool.
This explains why, in many cases, changes aren’t spotted until months after they have occurred and the scoliosis has already got worse.

The pubertal growth spurt is thus the most dangerous period of growth for those affected by adolescent scoliosis; in early-onset forms (infantile and juvenile scoliosis) it is also necessary to be highly vigilant in the periods 0-3 and 7-8 years, respectively, as these, too, are periods of rapid growth.

In any case, our advice is always to have a paediatrician or family doctor check a child’s back before the start of these rapid growth phases, in order to allow, if necessary, a timely referral to a spine specialist.
If there is already a family history of scoliosis it is recommended to have the youngster checked directly by a spine specialist every 3-4 months.