Scoliosis

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Scoliosis is a three-dimensional curvature of the spine. A normal spine is straight when viewed from the front or the back. Normally, when viewed from the side the spine curves backwards in the chest area (kyphosis) and forward in the waist area (lordosis). When viewed from the top down, all of the vertebrae should be facing forward. However, with scoliosis the spine curves to one side or the other in the thoracic and/or lumbar areas. From the top looking down through the center of the spine, some of the vertebrae are twisted which causes the ribs attached to the vertebrae to protrude, usually on the right side.  Scoliosis is a condition that may appear in more than one member of a family in the same or different generations. It does not develop as a result of anything that a child or her parents did or failed to do. Poor posture or carrying a heavy book bag does not case scoliosis. Scoliosis is a spinal deformity that usually appears during adolescence, although it may appear in younger children as well.

There are many causes for scoliosis. About 80%-85% of the patients have a type called IDIOPATHIC scoliosis. This means “no known cause.” Idiopathic scoliosis often runs in families and appears to be due to genetic or hereditary factors. It is not known what “triggers” the development of the curve or why some curves progress more than others. Scoliosis may occur in children who are otherwise perfectly healthy.  Also, scoliosis may be caused by NERVE AND MUSCLE DISORDERS, such as cerebral palsy, muscular dystrophy and polio. Other known causes of scoliosis include: CONGENITAL which is caused by abnormalities in the formation of the vertebrae present at birth, CONNECTIVE TISSUE DISORDERS such as Down’s Syndrome. Early diagnosis of the cause of scoliosis can aid in the proper treatment.  During adolescence scoliosis usually produces no pain and may be difficult to detect. Mild scoliosis may be present for several years before it is seen. One of the easiest ways to detect it is by using the forward beding examination. Most importantly, the physician should check the child’s spine regularly until growth is complete since scoliosis may appear at any time during adolescence. The curvature may progress considerably during the last major growth spurt.

When scoliosis is mild in adults, the condition may remain unchanged or progress so slightly over the years that no serious problems may develop. However, in some people significant changes may occur. Curves may increase in size causing pain and interfering with function. In the most severe cases, breathing also maybe a problem. Osteoporosis (thinning of the bone) later in life can cause a mind curvature to increase significantly. Prevention of osteoporosis is especially important in people with scoliosis. Scoliosis in adults may be the result of a curve not treated during adolescence. Also, scoliosis may be developed later in life, as a result of degeneration of the discs and joints of the spine.

One of the most common signs of scoliosis is a prominent shoulder blade, frequently the right one. One shoulder may also be higher and the child tends to “list” to one side. The hips maybe uneven and one seems to be higher than the other. Scoliosis should not be confused with poor posture. Very often the first indication of scoliosis is that there is something wrong with the fitting of clothes. This is very apparent in girls when observing the hemline of a skirt or dress. When a child with scoliosis bends forward, the appearance of a rib prominence is one of the most striking sighs.

According to the Scoliosis Research Society, about 10% of the adolescent population has some degree of scoliosis. This means that about 1,000,000 children just in the United States have scoliosis. About one fourth of these children will require medical attention which may consist of observation for further progression of the curve, bracing or surgery, depending upon the degree of the curvature at the time of its detection. Some scoliosis may be so mild that treatment may never be necessary.  Mild scoliosis occurs nearly as often in boys as in girls. More serious curves are five to eight times greater in girls than in boys.  Studies conducted throughout the world show there is a very even occurrence of scoliosis. There is virtually no variation of racial or ethnic incidence.