What is scoliosis?
Scoliosis is an abnormal curve in the spine.
- There are several types of scoliosis based on the cause and age when the curve develops; the majority of patients have no known cause.
- The most common symptom of scoliosis is curvature of the spine.
- Scoliosis risk factors include age (9-15-year-olds), female sex, and family history.
- Diagnosis is done by the physical exam and by imaging techniques such as X-rays, CT scans, or MRIs.
- Depending on the severity of the curve and the risk for it getting worse, scoliosis can be treated with observation, bracing, or surgery.
- The prognosis for an individual with scoliosis ranges from mainly good to fair, depending on how early the problem is diagnosed and treated.
- There is no cure for scoliosis but the symptoms can be reduced.
What is scoliosis?
Scoliosis is a disorder that causes an abnormal curve of the spine, or backbone. The spine has normal curves when looking from the side, but it should appear straight when looking from the front. Kyphosis is a curve in the spine seen from the side in which the spine is bent forward. There is a normal kyphosis in the middle (thoracic) spine. Lordosis is a curve seen from the side in which the spine is bent backward. There is a normal lordosis in the upper (cervical) spine and the lower (lumbar) spine. People with scoliosis develop additional curves to either side of the body, and the bones of the spine twist on each other, forming a "C" or an "S" shape in the spine.
Scoliosis is about two times more common in girls than boys. It can be seen at any age, but it is most common in those over about 10 years of age. Scoliosis is hereditary in that people with scoliosis are more likely to have children with scoliosis; however, there is no correlation between the severity of the curves from one generation to the next.
What are the symptoms for scoliosis?
Curved spine symptom was found in the scoliosis condition
Signs and symptoms of scoliosis may include:
- Uneven shoulders
- One shoulder blade that appears more prominent than the other
- Uneven waist
- One hip higher than the other
If a scoliosis curve gets worse, the spine will also rotate or twist, in addition to curving side to side. This causes the ribs on one side of the body to stick out farther than on the other side.
When to see a doctor
Go to your doctor if you notice signs or symptoms of scoliosis in your child. Mild curves, however, can develop without the parent or child knowing it because they appear gradually and usually don't cause pain. Occasionally, teachers, friends and sports teammates are the first to notice a child's scoliosis.
What are the causes for scoliosis?
Doctors don't know what causes the most common type of scoliosis — although it appears to involve hereditary factors, because the disorder tends to run in families. Less common types of scoliosis may be caused by:
- Neuromuscular conditions, such as cerebral palsy or muscular dystrophy
- Birth defects affecting the development of the bones of the spine
- Injuries to or infections of the spine
What are the treatments for scoliosis?
Most children with scoliosis have mild curves and probably won't need treatment with a brace or surgery. Children who have mild scoliosis may need checkups every four to six months to see if there have been changes in the curvature of their spines.
While there are guidelines for mild, moderate and severe curves, the decision to begin treatment is always made on an individual basis. Factors to be considered include:
- Sex. Girls have a much higher risk of progression than do boys.
- Severity of curve. Larger curves are more likely to worsen with time.
- Curve pattern. Double curves, also known as S-shaped curves, tend to worsen more often than do C-shaped curves.
- Location of curve. Curves located in the center (thoracic) section of the spine worsen more often than do curves in the upper or lower sections of the spine.
- Maturity. If a child's bones have stopped growing, the risk of curve progression is low. That also means that braces have the most effect in children whose bones are still growing.
If your child's bones are still growing and he or she has moderate scoliosis, your doctor may recommend a brace. Wearing a brace won't cure scoliosis or reverse the curve, but it usually prevents further progression of the curve.
The most common type of brace is made of plastic and is contoured to conform to the body. This close-fitting brace is almost invisible under the clothes, as it fits under the arms and around the rib cage, lower back and hips.
Most braces are worn day and night. A brace's effectiveness increases with the number of hours a day it's worn. Children who wear braces can usually participate in most activities and have few restrictions. If necessary, kids can take off the brace to participate in sports or other physical activities.
Braces are discontinued after the bones stop growing. This typically occurs:
- About two years after girls begin to menstruate
- When boys need to shave daily
- When there are no further changes in height
Severe scoliosis typically progresses with time, so your doctor might suggest scoliosis surgery to reduce the severity of the spinal curve and to prevent it from getting worse. The most common type of scoliosis surgery is called spinal fusion.
In spinal fusion, surgeons connect two or more of the bones in the spine (vertebrae) together, so they can't move independently. Pieces of bone or a bone-like material are placed between the vertebrae. Metal rods, hooks, screws or wires typically hold that part of the spine straight and still while the old and new bone material fuses together.
If the scoliosis is progressing rapidly at a young age, surgeons can install a rod that can adjust in length as the child grows. This growing rod is attached to the top and bottom sections of the spinal curvature, and is usually lengthened every six months.
Complications of spinal surgery may include bleeding, infection, pain or nerve damage. Rarely, the bone fails to heal and another surgery may be needed.
What are the risk factors for scoliosis?
Risk factors for developing the most common type of scoliosis include:
- Age. Signs and symptoms typically begin during the growth spurt that occurs just prior to puberty.
- Sex. Although both boys and girls develop mild scoliosis at about the same rate, girls have a much higher risk of the curve worsening and requiring treatment.
- Family history. Scoliosis can run in families, but most children with scoliosis don't have a family history of the disease.
Is there a cure/medications for scoliosis?
After your scoliosis diagnosis, you’ll be referred to an orthopedic doctor, who will work with you to determine the best way to treat your curved spine.
How your condition is managed depends on your age, the type of scoliosis you have, the measurement of your back’s curve, and your other medical conditions. For kids, the doctor will take into account how much more the patient is likely to grow.
They’ll also consider any symptoms you have that can be caused by severe curves, like pain, limited body function, and breathing problems. Your scoliosis treatment will fall into one of three categories:
- Nonsurgical options, such as a brace