Typical adolescent idiopathic scoliosis is not known to cause bladder problems. Urinary symptoms in a person with scoliosis matter because they can point to a spinal cord problem such as a tethered cord, to a congenital spine anomaly with kidney involvement, or to a complication after surgery. In 111 adolescents after posterior spinal fusion, Keskinen and colleagues found 46 percent could not void or had significant residual urine, and 27 percent had retention of 300 mL or more. New bowel or bladder change with back or leg symptoms needs same-day evaluation.
I am Dr. Justin Dick, DC, at Clear Life Scoliosis and Chiropractic Center in Charlotte, NC. Bladder questions are part of every scoliosis intake I do, and this post explains why.
Tethered Cord and Other Spinal Cord Abnormalities
A tethered cord is a spinal cord held abnormally low, which can stretch it with growth. Yaltırık and colleagues' systematic review of 13 articles on scoliosis with tethered cord (outside spina bifida) found that asymptomatic patients could be managed as scoliosis, while symptomatic patients with curves under 35° might see curve improvement after untethering. Xu and colleagues reviewed 714 adolescents with scoliosis who had whole-spine MRI and found intramedullary abnormalities in 9.5 percent, with male sex, a left thoracic curve, a sharply angled curve, abnormal abdominal reflexes, and ankle clonus as independent risk factors. Bladder change with any of those features is a reason for MRI.
Congenital Scoliosis and the Kidneys
Basu and colleagues found urogenital anomalies in 21 percent of 126 children with congenital spine deformity. My post on what causes scoliosis covers congenital curves.
Kidney Findings Before Surgery
Suzuki and colleagues imaged 16 adolescents with idiopathic scoliosis before surgery and found renal pelvis dilatation on ultrasound in half and urinary tract obstruction on radioisotope scanning in 6 (37.5 percent). With 16 patients, that is a signal worth studying, not a prevalence figure.
After Spinal Fusion
Keskinen's series found postoperative retention was common, and boys had 3.2 times the odds. Retention after fusion is usually managed in hospital. My post on care after spinal fusion covers recovery.
Red Flags
Dionne and colleagues reviewed 7 studies of 569 patients and found that red flags for cauda equina syndrome had pooled sensitivity of only 0.19 to 0.43 and specificity of 0.62 to 0.88. Red flags miss many cases, so their presence calls for prompt imaging and their absence does not rule the condition out. Our spine emergencies page lists the signs.
How Dr. Justin Dick, DC Screens for Urinary Symptoms at Clear Life
At our Charlotte office, every scoliosis intake asks about bladder and bowel function, and the exam includes reflexes and clonus. Abnormal findings lead to MRI and specialist referral, not to watching.
Comparison
| Situation | Finding | Source |
|---|---|---|
| After posterior spinal fusion | 46% unable to void or significant residual | Keskinen 2018, 111 patients |
| Intramedullary abnormality on MRI | 9.5% of adolescents imaged | Xu 2020, 714 patients |
| Congenital spine deformity | 21% urogenital anomalies | Basu 2002, 126 children |
| Before surgery, idiopathic scoliosis | Urinary tract obstruction in 6 of 16 | Suzuki 2017 |
| Cauda equina red flags | Sensitivity 0.19 to 0.43 | Dionne 2019, 7 studies |
Research and Evidence
Evidence tiering: Yaltırık and Dionne are systematic reviews; Xu and Keskinen retrospective cohorts; Basu a consecutive case series; Suzuki a very small case series. The statement that typical idiopathic scoliosis is not known to cause bladder problems reflects the absence of supporting evidence I could find, not a study proving no link.
My own published work concerns idiopathic scoliosis care. The 13-month follow-up case, Reduction of Adolescent Idiopathic Scoliosis: A 13-Month Follow-Up (Cureus, 2025, PMID 40062184), reports one adolescent and does not address urinary symptoms.
References
- Keskinen H, Helenius L, Pajulo O, Helenius IJ. Postoperative urinary retention or difficulties to empty the bladder in young patients undergoing posterior spinal fusion for adolescent idiopathic scoliosis. J Pediatr Surg. 2018;53(8):1542-1546. doi:10.1016/j.jpedsurg.2017.09.023
- Yaltırık K, El Tecle NE, Pierson MJ, et al. Management of concomitant scoliosis and tethered cord syndrome in non-spina bifida pediatric population. Childs Nerv Syst. 2017;33(11):1899-1903. doi:10.1007/s00381-017-3504-0
- Xu W, Zhang X, Zhu Y, et al. An analysis of clinical risk factors for adolescent scoliosis caused by spinal cord abnormalities in China: proposal for a selective whole-spine MRI examination scheme. BMC Musculoskelet Disord. 2020;21(1):187. doi:10.1186/s12891-020-3182-z
- Basu PS, Elsebaie H, Noordeen MH. Congenital spinal deformity: a comprehensive assessment at presentation. Spine. 2002;27(20):2255-9. doi:10.1097/00007632-200210150-00014
- Suzuki S, Kotani T, Mori K, Kawamura K, Ohtake A. Preoperative urinary tract obstruction in scoliosis patients. Pediatr Int. 2017;59(1):48-52. doi:10.1111/ped.13115
- Dionne N, Adefolarin A, Kunzelman D, et al. What is the diagnostic accuracy of red flags related to cauda equina syndrome (CES), when compared to magnetic resonance imaging (MRI)? A systematic review. Musculoskelet Sci Pract. 2019;42:125-133. doi:10.1016/j.msksp.2019.05.004
- Dick JM, Spurgeon S. Reduction of adolescent idiopathic scoliosis: a 13-month follow-up. Cureus. 2025;17(2):e78669. doi:10.7759/cureus.78669
Frequently Asked Questions
Can scoliosis cause bladder problems?
Typical adolescent idiopathic scoliosis is not known to cause them. Bladder symptoms with scoliosis can point to a tethered cord or other spinal cord abnormality and need evaluation.
What is a tethered cord?
A spinal cord held abnormally low that can be stretched with growth. It can occur with scoliosis and may affect bladder function.
Is urinary retention common after scoliosis surgery?
Yes. In 111 adolescents after posterior spinal fusion, 46 percent could not void or had significant residual urine.
When are bladder symptoms an emergency?
New bladder or bowel change with back pain, leg weakness, or numbness in the groin needs same-day evaluation.
Should a child with scoliosis and bladder problems get an MRI?
Usually yes. Dr. Justin Dick, DC at Clear Life Scoliosis in Charlotte, NC refers for MRI when bladder change appears with abnormal reflexes, clonus, or atypical curve features.
Where can I get scoliosis evaluated in Charlotte, NC?
Clear Life Scoliosis and Chiropractic Center, 8814 Rachel Freeman Way, Suite 103, Charlotte, NC 28278, provides scoliosis evaluation with Dr. Justin Dick, DC. Call 980-368-0766.
Service Area
Clear Life Scoliosis and Chiropractic Center sees patients from Charlotte NC, Huntersville NC, Ballantyne NC, Matthews NC, Concord NC, Mooresville NC, Rock Hill SC, Fort Mill SC. Families from across the Charlotte region and the South Carolina border communities come to the Rachel Freeman Way office for radiographic scoliosis evaluation with Dr. Justin Dick, DC.
Related Pages
- Spine Emergencies
- Care After Spinal Fusion
- Scoliosis Surgery Risks and Outcomes
- What Causes Scoliosis
- Infantile Scoliosis
- Juvenile Scoliosis
- For Parents of Teens With Scoliosis
- Types of Scoliosis
- Scoliosis Care Program
- Dr. Justin Dick, DC Research
Schedule an Evaluation in Charlotte
If bladder symptoms have appeared alongside a curve, they deserve an exam first. Dr. Justin Dick, DC screens for them at our Charlotte office.
Dr. Justin Dick, DC · ORCID 0009-0001-2794-2159
8814 Rachel Freeman Way, Suite 103, Charlotte, NC 28278
Phone: 980-368-0766 · Email: office@clearlifescoliosis.com
clearlifescoliosis.com · Book online
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