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Scoliosis

What is Scoliosis?

Scoliosis Scoliosis is an abnormal curvature of the spine wherein the spine curves in an S formation. The condition predominantly affects adolescents between the ages of 9 and 16 and occurs more frequently in females than in males. While the majority of scoliosis cases are mild, some children develop disabling spine deformities which reduce the amount of space in their chest and affect lung function.

While there is no cure for scoliosis, the good news is that individuals with scoliosis can live full, normal, productive lives, can get pregnant, and can have children with no increased risk. Furthermore, thanks to school screening programs and heightened awareness, earlier identification of scoliosis is on the rise.

Types of Scoliosis

The most common type of scoliosis is idiopathic, meaning there is no known cause for the disorder. Depending on what age a person is when scoliosis develops, this is further broken down into the following categories:

  • Infantile idiopathic scoliosis (less than 3 years old)
  • Juvenile idiopathic scoliosis (between 3 and 10 years old)
  • Adolescent idiopathic scoliosis (over10 years old)

Other types of scoliosis can be caused by:

  • Neuromuscular disorders (i.e. muscular dystrophy or cerebral palsy)
  • Birth defects which affect how the bones of the spine develop
  • Spinal infections or injuries

Risk Factors for Developing Scoliosis

The following risk factors are associated with scoliosis:

  • Individuals aged 9-15, or during the growth spurt which occurs just before puberty
  • Girls, who have a higher risk of developing more severe spinal curves which require treatment
  • Heredity, since scoliosis can run in families

Scoliosis Signs and Symptoms

Signs and symptoms of scoliosis may include:

  • Gradual changes in the curvature of the spine
  • One shoulder blade appears more pronounced than the other
  • Pant legs are longer on one side than the other
  • One hip is higher than the other
  • Uneven waist
  • Rotated, twisted spine
  • Back pain
  • Chest pain
  • Difficulty breathing

Scoliosis Treatment

Treatment of scoliosis depends up the severity of the curve and the chances of the curve worsening. The three primary types of treatment for idiopathic scoliosis are:

  • Observation or monitoring of the curve to see if the condition is getting worse
  • Bracing to prevent curve from getting worse until the person stops growing
  • Surgery in cases of severe scoliosis

In general:

  • Curves measuring less than 25 degrees require no further treatment
  • Curves measuring between 25-40 degrees may benefit from a brace in individuals who are still growing
  • Curves measuring greater than 40 degrees may require surgery

Since coping with scoliosis is extremely difficult for children and adolescents, a support group and/or supportive peer group can be highly beneficial. Children and teens with scoliosis are encouraged to talk about their fears, anger and anxieties, their emotional and physical challenges, and to offer each other support and advice.

Braces for Soliosis

A brace may be recommended for children who have mild to moderate scoliosis and who are still growing. The goal of a brace is to prevent further progression of the curve. The two main types of braces are:

  • Milwaukee brace
  • Underarm brace (thoracolumbosacral orthosis)

Treatment for Other Types of Scoliosis

In functional scoliosis the spine is normal however the curvature is caused by an abnormality somewhere else in the body, such as a difference in leg length. In these cases, scoliosis is treated by treating the abnormality, i.e. placing a wedge inside one’s shoe to help even out leg length and prevent the spine from curving.

In neuromuscular scoliosis, an abnormal development of the bones of the spine causes spine curvature. In the majority of these cases, surgery may be needed to prevent the curve from getting worse.

Complications of Scoliosis

Severe forms of scoliosis can lead to the following complications:

  • Noticeably abnormal physical appearance, including uneven shoulders, uneven hips, waist and trunk shifted to one side, prominent ribs
  • As the condition worsens, affected individuals often become self-conscious about how they look
  • Lung damage
  • Heart damage
  • Chronic back pain

Surgery for Scoliosis

The most common type of surgery for scoliosis is spinal fusion. The goals of surgery are:

  • To correct and stabilize the curve
  • Prevent curve from getting worse
  • Reduce pain
  • Restore a more normal appearance to the spinal column