Scoliosis

What is Scoliosis?

Scoliosis is an abnormal lateral curvature of the spine. It is most often diagnosed in childhood or early adolescence. The spine's normal curves occur at the cervical, thoracic and lumbar regions. These natural curves position the head over the pelvis and work as shock absorbers to distribute mechanical stress during movement. Scoliosis is often defined as spinal curvature in the “coronal” (frontal) plane. 

Causes of scoliosis-

Scoliosis can be classified by etiology: idiopathic, congenital or neuromuscular. 

Idiopathic scoliosis is the diagnosis when all other causes are excluded and comprises about 80 percent of all cases. 

Congenital scoliosis results from embryological malformation of one or more vertebrae. Because these abnormalities are present at birth, congenital scoliosis is usually detected at a younger age than idiopathic scoliosis.

Neuromuscular scoliosis encompasses scoliosis that is a part of any neurological or muscular disease. This includes scoliosis associated with cerebral palsy, spinal cord trauma, muscular dystrophy, spinal muscular atrophy and spina bifida. This type of scoliosis progresses faster than idiopathic scoliosis and requires surgical treatment.

Symptoms of scoliosis-

There are several signs that may indicate the possibility of scoliosis. Some symptoms include:

• Shoulders are uneven – one or both shoulder blades may stick out
• Head is not centered directly above the pelvis
• One or both hips are raised or unusually high
• Rib cages are at different heights
• Waist is uneven
• The appearance or texture of the skin overlying the spine changes (dimples, hairy patches, color abnormalities)
• The entire body leans to one side

Diagnosis-

Scoliosis is typically diagnosed by a physician after a physical exam and imaging. The type of imaging that can be used for a positive and accurate diagnosis include x-ray, CT scan, or MRI. It is important to remember that scoliosis can be diagnosed in children and adults, however the goals of treatment may differ based on age.

Treatment-

When there is a confirmed diagnosis of scoliosis, there are several issues to assess that can help determine treatment options:

Spinal maturity – is the patient's spine still growing and changing?

Degree and extent of curvature – how severe is the curve and how does it affect the patient's lifestyle?

Location of curve – according to some experts, thoracic curves are more likely to progress than curves in other regions of the spine.

Possibility of curve progression – patients who have large curves prior to their adolescent growth spurts are more likely to experience curve progression.

After these variables are assessed, the following treatment options may be recommended:

• Observation
• Bracing
• Surgery