1. What is scoliosis?

 

Scoliosis is an abnormal sideways curvature of the spine. The curves are often S-shaped or C-shaped.

 

2. What are the signs and symptoms of scoliosis?

 

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
  • Leaning to one side

In more advanced cases of scoliosis, the ribs on one side of the body may stick out farther than on the other side, due to spine rotation/twisting. Severe scoliosis can also cause back pain and difficulty breathing.

 

3. What are the causes of scoliosis?

 

In approximately 80% of scoliosis cases, the cause is unknown.  When a cause cannot be identified, the scoliosis is called idiopathic.

 

Doctors classify curves as:

  • Nonstructural, which is when the spine is structurally normal and the curve is temporary
  • Structural, which is when the spine has a fixed curve. The cause could be a disease, injury, infection or a birth defect. 

Scoliosis tends to run in families and may involve genetic (hereditary) factors. However, researchers have yet to identify the gene or genes that may cause scoliosis. Doctors also presently recognize that spinal cord and brainstem abnormalities play a role in some cases of scoliosis.

 

Scoliosis, however, is NOT caused by:

  • Poor posture
  • Diet
  • Exercise
  • Use of backpacks

 

4. What are the risk factors for scoliosis?

 

Scoliosis is often first noticed just before and during adolescence, during a growth spurt. Growth is the biggest risk factor for worsening of an existing curve.

 

Although infantile idiopathic scoliosis is more common in boys, the other forms-congenital, juvenile (ages 3 to 10) and adolescent (older than 10)- are more common in girls.

 

Other than growth, risk factors that make it more likely that a scoliosis curve will get worse include:

  • Sex: Curves in girls are more likely to worsen than curves in boys.
  • Age: The younger the child when scoliosis appears, the greater the chance the curve will worsen.
  • Angel of the curve: The greater the curve angle, the higher the likelihood that it will worsen.
  • Location: Curves in the middle to lower spine are less likely to progress than those in the upper spine.
  • Spinal problems at birth: Children who are born with scoliosis (congenital scoliosis) may have rapid progression of the curve. Congenital scoliosis is thought of as a birth defect in the spine itself.

 

5. How is scoliosis diagnosed?

 

Doctors use a medical and family history, physical exam and tests when checking a person for scoliosis.

 

Your doctor may take the following diagnostic steps:

  • Physical Examination: Your doctor examines the spine as well as the shoulders, hips, legs and rib cage for signs of scoliosis.
  • X-rays: Your doctor may do an initial X-ray to confirm the diagnosis and determine the curve angle. After that, periodic X-rays are done to monitor the curve and help make treatment decisions.

 

6. What are possible complications?

 

Possible complications of scoliosis include:

  • Lung and Heart Damage: In severe scoliosis- a curve greater than 70 degrees- the rib cage may press against the lungs and heart, making it more difficult to breathe and harder for the heart to pump. In very severe scoliosis- a curve greater than 100 degrees- damage to the lungs and heart can occur.
  • Back Problems: Adults who had scoliosis as children are more likely to have chronic back pain than do people in the general population. Also, people with untreated scoliosis may develop arthritis.
  • Body Image: Children may feel isolated and develop a poor body image from wearing a brace during childhood and teenage years. Parents should try to keep children involved in activities that build confidence and encourage friendships and normalcy whenever possible.

 

7. What are the treatment options?

 

Treatment for scoliosis is based on:

  • The person's age
  • How much more s/he is likely to grow
  • The degree and pattern of the curve
  • The type of scoliosis

Based on these factors, the doctor may recommend observation, bracing or surgery.

 

  • Observation:

The doctor will check every 4 to 6 months to see if the curve is getting better or worse. Observation is used for those who have a curve of less than 25 degrees and are still growing

 

  • Bracing:

Doctors may advise wearing a brace to stop a curve from getting worse. Bracing may be used when:

1. The person is still growing and has a curve of more than 25 to 30 degrees.

2. The person is still growing and has a curve between 20 and 29 degrees that is getting worse.

3. The person has at least 2 years of growth remaining and has a curve that is between 20 and 29 degrees. If a girl, she should not have started having her monthly periods yet.

 

  • Surgery:

       Doctors use surgery to correct a curve or stop it from getting worse when the person is still growing, the curve is more than 45 degrees and the curve is getting worse. Surgery often involves fusing together two or more bones in the spine. The doctor may also put in a metal rod or other device. These devices are called implants.

 

8. When should you seek medical attention?

 

Development of scoliosis is usually gradual and almost always painless. Early detection is important to start treatment that can prevent the curve from getting worse. For this reason, many schools provide screening for scoliosis.

 

Be sure to have your child see a doctor if there is a family history of scoliosis. Although rare, scoliosis has the potential to lead to serious health problems.

 

Information provided in this section has been taken from:  

 

Mayo Clinic's Scoliosis Site http://www.mayoclinic.com/health/scoliosis/DS00194/DSECTION=1)US

 

 Dept. of Health and Human Services' Public Health Service Brochure on Scoliosis http://www.niams.nih.gov/hi/topics/scoliosis/FF_Scoliosis.pdf