Overview of Scoliosis
coliosis is defined as an abnormal curvature of the spine. When viewed from the front or back, a normal spine forms a straight line from the top of the neck, down to the bottom of the back. However, in scoliosis, the spine may curve to the left or the right side. This most commonly occurs in either the middle of the back (thoracic spine) or the lower part of the back (lumbar spine). About 2-3% of the general population suffers from some degree of scoliosis, and most cases are mild, requiring no treatment. There are two main types of scoliosis:
- Idiopathic Scoliosis is seen early in life, typically during growth spurts in children and adolescents. Pediatricians screen for this type of scoliosis during regular checkups.
- Degenerative Scoliosis occurs in adults as a result of wear-and-tear, and arthritis of the spine. As the joints and ligaments of the spine degenerate, they may not hold the proper alignment of vertebral bodies, resulting in abnormal curvature. Sometimes, degenerative scoliosis in an adult represents worsening of a previously mild, idiopathic scoliosis from childhood.
While scoliosis can cause back pain, the degree of scoliosis can determine the severity of the pain. Patients with a greater curvature of their spine will often have worse pain. In addition, signs of scoliosis can be evident before the onset of pain. Signs of scoliosis can include:
- Appearance of body leaning to one side
- Uneven shoulders or hips
- Elevation of waist or rib cage on one side
- Asymmetrical muscle bulk along the spine
- Gait disturbance or abnormal walking pattern
Severe scoliotic deformities can interfere with the proper functioning of internal organs, such as the lungs
When to see a Medical Practitioner
If you have any of the above signs or symptoms of scoliosis, or notice them in your child, call to make an appointment for further evaluation. Mild cases typically do not require treatment. However, yearly follow-ups may be necessary to track any progression in curvatures of the spine over time. Bracing or treatment with physical therapy to strength the muscles around the spine may also be required to treat early or symptomatic scoliosis.
Idiopathic scoliosis is by far the most common type of scoliosis, which can begin in teenagers around the onset of puberty or can occur in adults with aging. Females have a higher risk of developing scoliosis in this age group. In older adults, physical deconditioning can allow for the earlier development of arthritis which can increase the risk of developing degenerative scoliosis.
Pt with neuromuscular diseases such as cerebral palsy, spina bifida, muscular dystrophy and other paralytic conditions can also increase the risk for the development of scoliosis.
Scoliosis can lead to the following possible complications:
- Back pain
- Noticeable physical changes in the appearance of the shoulder, back, hips or when walking
- Limitations of heart and lung function if severe scoliosis decreases the space in which those organs use to work properly
Treatment of Scoliosis
Often, scoliosis requires little or no treatment. Mild to moderate cases can be treated with bracing and/or a combination of physical therapy. Physical therapy, core abdominal strengthening and maintaining a healthy weight are the best treatments for mild to moderate scoliosis, and help prevent progression of deformity. Severe cases of scoliosis, or those cases in which heart or lung function is compromised, often require deformity correction surgery, where the curved spine is straightened with titanium screws and rods.