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Scoliosis

Alternative name: Curvature of the Spine

What is scoliosis?

Scoliosis (curvature of the spine) is a disorder in which the backbone gradually bends sideways. There is more than one type of scoliosis and it can affect people at various ages and has different causes.

What are the signs of scoliosis?

  • The spine curves abnormally to the side (laterally)
  • The shoulders and/or hips seem uneven

What causes scoliosis?

There are three general causes of scoliosis:

  • Unknown cause (idiopathic), mostly in adolescents*, during growth spurts, more commonly in girls, and there may be a genetic component
  • Since birth (congenital), usually related to a problem with the formation of the spine or ribs during prenatal development
  • Nerves and muscle-related (neuromuscular), poor muscle control or muscular weakness or paralysis due to diseases like cerebral palsy, muscular dystrophy, spina bifida, and polio

*Routine scoliosis screening is now done in junior high school and middle school, so many adolescent cases of scoloisis are detected in this way

How does a doctor tell if a patient has scoliosis?

Your doctor may take some of the following steps to see if you or your child has scoliosis:

  • Take a medical history by asking questions about your family's health, especially to find out if any relative has had scoliosis
  • Perform a physical examination by looking at the patient's back, legs, hips, feet and skin and by asking the patient to stand, walk, and bend over to check if there is a difference between the sides of the body
  • Arrange for a neurologic examination
  • Order X-rays to get a clear view of the backbone, if indicated
  • Measure the curves on the X-ray to see if they are greater than 10 degrees

How is scoliosis normally treated?

The choice of treatment depends on the kind of scoliosis a patient has. Children and adolescents usually require no treatment unless the curvature is more than 25 degrees; however, having a check-up two to three times a year is advised. If the curve is more pronounced (25-40 degrees), often a brace is used to help to slow the process. There are many types of braces and the one selected will depend on the type of curvature.

Bracing is not used in slight congenital (from birth) or neuromuscular scoliosis. Curves of 40 degrees or greater usually need surgery because curves this large have a high risk of progressing even after the bone stops growing.

Physical therapy and emotional support can be helpful additions to the treatment plan.

Exercise: Studies have shown that exercise alone will not stop progressive curves. However, patients may wish to exercise for the effects on their general health and well-being.

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