Scoliosis & Kyphosis (Curved Spine) In Singapore

Living with a curved spine can affect your posture, movement, and quality of life. Whether you’ve noticed changes in your spine alignment or been diagnosed with scoliosis or kyphosis, understanding these conditions is the first step toward management. Our clinic provides comprehensive evaluation and treatment for spinal curvatures, helping patients of all ages achieve better spinal health and function.

Dr Zackary Chua

Senior Consultant Orthopaedic Surgeon (Adult & Paeds)

MBBS (Aus)MMed (SG)MRCS (Glasgow)FRCSEd (Orth)

Types Causes & Risks Symptoms When to see a Doctor Diagnosis Treatment Complications Prevention FAQ Conclusion

What is Scoliosis & Kyphosis?

Scoliosis and kyphosis are spinal deformities that cause abnormal curvature of the spine. Scoliosis involves a sideways curvature creating an “S” or “C” shape when viewed from behind, while kyphosis causes excessive forward rounding of the upper back. These conditions can occur separately or together, affecting people across all age groups. In Singapore, approximately 2-3% of adolescents have some degree of scoliosis, with similar prevalence rates for kyphosis. While mild curves may cause minimal symptoms, progressive curvatures can lead to pain, breathing difficulties, and reduced mobility.

Types of Spinal Curvatures

Scoliosis Types

Idiopathic Scoliosis: It typically develops during growth spurts in adolescence but can appear in younger children or adults.
Congenital Scoliosis: Presents at birth due to abnormal vertebral development during foetal growth. This type often requires early intervention as curves can progress rapidly during growth periods.
Neuromuscular Scoliosis: Develops secondary to neurological or muscular conditions such as cerebral palsy, muscular dystrophy, or spinal cord injuries. These curves tend to progress more rapidly and require specialised management.
Degenerative Scoliosis: Occurs in adults due to age-related wear and tear of spinal discs and joints. This type affects individuals over 50 and may be associated with spinal stenosis or disc degeneration.

Kyphosis Types

Postural Kyphosis: The most benign form, caused by poor posture and slouching. This flexible curve can be corrected through conscious effort and strengthening exercises.
Scheuermann’s Kyphosis: A rigid deformity that develops during adolescence due to wedge-shaped vertebrae. Unlike postural kyphosis, this structural curve cannot be corrected by improving posture alone.
Congenital Kyphosis: Results from malformed vertebrae present at birth. This rare but serious condition may require surgical intervention to prevent neurological complications.

Causes

Genetic Factors: Family history plays a significant role, particularly in idiopathic scoliosis. Having a parent or sibling with scoliosis increases your risk of developing the condition.
Developmental Abnormalities: Congenital forms result from improper vertebral formation during foetal development, including failure of vertebrae to form properly or separate.
Underlying Medical Conditions: Neuromuscular diseases, connective tissue disorders like Marfan syndrome, and previous spinal injuries or infections can lead to spinal curvature.
Age-Related Changes: Degenerative changes in spinal discs and joints, osteoporosis, and compression fractures contribute to adult-onset curvatures.

Risk Factors

Age (rapid growth periods in adolescence)
Gender (girls have a higher risk of curve progression)
Family history of spinal deformities
Neuromuscular conditions
Previous spinal surgery or radiation
Osteoporosis in older adults
Poor posture habits during developmental years
Participation in activities causing spinal asymmetry

Signs & Symptoms

Mild Curvature (10-25 degrees)

Slight shoulder height difference. Over time, this asymmetry can cause severe muscular strain and impingement on the lower shoulder, often requiring evaluation by an orthopaedic shoulder specialist.
Mild waist asymmetry
One hip appearing higher
Clothes fitting unevenly
Minor rib prominence when bending forward
Occasional back fatigue after prolonged sitting

Moderate Curvature (25-50 degrees)

Visible spine curvature
Pronounced shoulder blade protrusion
Significant waist asymmetry
Noticeable rib hump when bending
Back pain during activities
Reduced flexibility
Early fatigue with physical activity

Severe Curvature (>50 degrees)

Obvious spinal deformity
Chronic back pain
Breathing difficulties
Reduced lung capacity
Digestive issues
Limited physical endurance
Heart complications
Neurological symptoms in rare cases

Symptoms become more noticeable during growth spurts in adolescence or gradually worsen with age in adult-onset cases. Early detection through regular screening allows for timely intervention before the disease progresses significantly.

Experiencing these symptoms? Don’t wait for them to worsen.

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When to See a Doctor

Seek medical evaluation if you notice asymmetry in shoulder height, waist appearance, or rib prominence. Red flag symptoms requiring immediate attention include sudden onset of severe back pain, numbness or weakness in the legs, loss of bowel or bladder control, or breathing difficulties. For children and adolescents, annual spine checks during growth years are recommended if there’s a family history of scoliosis.

During your first consultation, our orthopaedic surgeon will perform a comprehensive physical examination including the Adams Forward Bend Test to assess spinal alignment. X-rays will be taken to measure curve angles and determine the appropriate treatment approach. Early intervention is crucial for growing children, as smaller curves are easier to manage and less likely to require surgery.

Diagnosis & Testing Methods

A diagnosis begins with a detailed medical history and physical examination. The Adams Forward Bend Test helps identify spinal asymmetries and rib prominences characteristic of scoliosis. Our orthopaedic surgeon will assess shoulder heights, waist symmetry, and spinal alignment while standing and bending.

X-rays remain the standard for measuring curve severity using the Cobb Angle method. Full-length standing spine X-rays taken from front and side views reveal the exact location, pattern, and degree of curvature. For growing children, we may use specialised imaging techniques that minimise radiation exposure while providing accurate measurements.

MRI scanning may be recommended if neurological symptoms are present or if the curve pattern suggests an underlying spinal cord abnormality. This detailed imaging helps identify compression of neural structures or associated conditions requiring specific treatment. For surgical planning, CT scans provide three-dimensional visualisation of vertebral anatomy, ensuring precise surgical execution.

Treatment Options Overview

Observation and Monitoring

For mild curves (less than 25 degrees) in growing children or stable curves in adults, regular monitoring every 4-6 months tracks progression. This approach includes periodic X-rays and clinical assessments to ensure curves remain stable without active intervention.

Physiotherapy and Exercise

Specialised physiotherapy programmes strengthen core muscles, improve posture, and maintain spinal flexibility. Schroth Method exercises, designed for scoliosis, teach patients three-dimensional corrective movements that can help manage mild to moderate curves.

Bracing Treatment

For growing adolescents with moderate curves (25-40 degrees), custom-fitted braces worn 16-23 hours daily can prevent progression. Modern braces are less visible under clothing and allow for normal activities while providing corrective forces to the spine.

Pain Management

Adults with degenerative scoliosis may benefit from targeted pain relief, such as anti-inflammatory medications, muscle relaxants, or specific injection therapies. Facet joint injections or epidural steroid injections can help reduce inflammation-related pain in affected areas.

Spinal Decompression

For curves causing nerve compression, procedures like laminectomy or foraminotomy can relieve pressure. While these minimally invasive techniques may improve symptoms, it doesn’t correct the curvature of the spine, addressing the root cause.

Corrective Surgery

Severe curves (over 50 degrees) or rapidly progressing curves may be considered for spinal fusion surgery. Modern techniques use titanium rods and screws to stabilise the spine, helping control the curve while maintaining functional outcomes.

Growth-Friendly Surgery

For young children with severe early-onset scoliosis, expandable implants allow continued growth while controlling curve progression. These systems require periodic adjustments but preserve spine growth potential during developmental years.

Every patient’s condition is unique.

Our Senior Consultant Orthopaedic Surgeon will assess your condition and recommend a suitable treatment approach for you.

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Complications if Left Untreated

Untreated progressive scoliosis and kyphosis can lead to health complications beyond cosmetic concerns. Severe thoracic curves may reduce chest cavity space, potentially affecting lung function and causing breathing difficulties during physical activities, which can place additional strain on the heart.

Chronic back pain may develop as abnormal spinal mechanics contribute to disc degeneration and arthritis. Altered biomechanics can increase stress on certain spinal segments, sometimes leading to early wear and nerve compression. Adults with untreated adolescent scoliosis may experience increased back discomfort and reduced mobility later in life.

The impact on quality of life extends beyond physical symptoms. Visible spinal curvature can influence self-esteem and social interactions during adolescence. Progressive curves may also affect participation in recreational activities or certain work tasks, highlighting the importance of timely evaluation and appropriate management.

Prevention

While genetic forms of scoliosis and kyphosis cannot be prevented, certain measures may help reduce the risk of postural kyphosis and limit progression of existing curves. Maintaining good posture during daily activities, especially when using electronic devices, can help prevent postural deformities. Regular stretching and strengthening exercises for the core and back muscles provide additional spinal support.

For growing children, backpacks should weigh no more than 10–15% of body weight and be worn on both shoulders. Encourage a variety of physical activities that promote balanced muscle development rather than repetitive one-sided movements. Adequate calcium and vitamin D intake supports bone health and may help prevent age-related kyphosis.

Regular spine screenings during adolescent growth spurts allow early detection when treatment is most effective. In Singapore, schools conduct annual scoliosis screenings, but parents should also monitor for signs of spinal asymmetry at home. Maintaining a healthy weight can reduce stress on the spine and may help slow the progression of degenerative curves in adults.

Scoliosis & Kyphosis

Frequently Asked Questions

Can scoliosis or kyphosis be cured without surgery?

While structural curves cannot be “cured” without surgery, many cases can be managed with non-surgical treatments. Mild curves remain stable with observation alone. Moderate curves in growing children may be controlled with bracing, and adults can manage symptoms through physical therapy, exercises, and pain management strategies. Our orthopaedic surgeon will determine the appropriate approach based on curve severity, age, and progression risk.

At what age should children be screened for scoliosis?

Screening begins around age 10-12, coinciding with pre-adolescent growth spurts when curves are likely to progress. In Singapore, school health services conduct annual screenings, but parents should watch for signs like uneven shoulders or prominent shoulder blades. Children with family history of scoliosis may benefit from earlier and more frequent evaluations by an orthopaedic specialist.

Will scoliosis get worse during pregnancy?

Most women with scoliosis have normal pregnancies without curve progression. Pre-existing back pain may increase due to postural changes and weight gain. Curves greater than 30 degrees have slightly higher risk of progression. Our orthopaedic surgeon can provide specific guidance for managing scoliosis during pregnancy and recommend safe pain relief options.

How long is recovery after scoliosis surgery?

Initial hospital stay lasts 4-7 days, with gradual return to normal activities over 3-6 months. Patients can walk the day after surgery and return to school or desk work within 4-6 weeks. Full fusion and unrestricted activities occur by 6-12 months. Our team provides comprehensive post-operative care and rehabilitation guidance throughout recovery.

Can adults develop scoliosis for the first time?

Yes, degenerative scoliosis can develop in adults without prior spine problems after age 50. Age-related disc degeneration, osteoporosis, and spinal arthritis contribute to new curve formation. These curves cause more symptoms than adolescent scoliosis due to associated spinal stenosis and reduced flexibility. Treatment focuses on symptom management and maintaining function.

Is scoliosis hereditary?

Genetic factors play a significant role in idiopathic scoliosis, with approximately 30% of patients having a family history. Having a parent or sibling with scoliosis increases risk, though inheritance patterns are complex. Not everyone with genetic predisposition develops scoliosis, and severity can vary within families. Genetic counselling may be helpful for families with multiple affected members.

Conclusion

Scoliosis and kyphosis are manageable conditions when properly evaluated and treated. Early detection and appropriate intervention can prevent progression, reduce symptoms, and maintain quality of life. Whether you’re concerned about your child’s posture or experiencing adult-onset spinal changes, our comprehensive approach addresses each patient’s unique needs. Modern treatment options range from observation and conservative management to surgical techniques, ensuring outcomes for every curve type and severity.

Take the First Step Towards Better Spinal Health

Living with scoliosis or kyphosis can be challenging, but you don’t have to face it alone. Our Senior Consultant Orthopaedic Surgeon has experience diagnosing and treating curved spine conditions using evidence-based approaches.

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Dr Zackary Chua (蔡克祥医生)

Senior Consultant Orthopaedic Surgeon (Adult & Paeds)

MBBS (AUS)|MMed (Singapore)|MRCS (Glasgow)|FRCSEd (Orth)

A senior consultant orthopaedic surgeon with dual specialisations in Foot & Ankle Surgery and Paediatric Orthopaedics. Backed by his extensive years of training and experience, Dr Chua brings the necessary knowledge and skills to ensure a smooth recovery journey.

Rooted firmly by two fundamental philosophies: “When one’s feet hurt, one hurts all over” and “Children are not little adults”, Dr Chua’s approach to patient care reflects his compassionate care for adults and children.

Singhealth Quality Excellence Award – Silver (2011)
Service From the Heart Award (2021)
Singapore Health Quality Service Award – Gold (2023)
NUS Medicine Dean’s Award for Teaching Excellence (2023)

His active participation in the medical community extends to mentoring, research supervision, and contributions to key professional forums and symposiums, both locally and internationally.