What Is Scoliosis?
Scoliosis is defined as an abnormal sideways curvature of the spine. A normal spine appears as a straight line when viewed head-on. In a patient with scoliosis, the spine appears as an “S” or “C” shape when viewed head-on. Scoliosis can range from very mild and harmless to severe and debilitating. The severity of scoliosis is determined by a measured degree of curvature, with mild cases measuring under 20 degrees and more severe cases measuring over 40 degrees. Scoliosis is found in approximately 3% of the population and affects females more than males.
While the exact cause of scoliosis is unknown, research shows that it may be hereditary because many patients have family members that also have scoliosis. In less common cases, scoliosis can be caused by the following underlying conditions:
- Spina bifidia
- Muscular dystrophy
- Ehlers-Danlos Syndrome
- Chiari Malformation
- Cerebral palsy
- Marfan syndrome
- Amniotic band syndrome
There are four types of scoliosis, defined by the area of the spine in which the curvature occurs.
Thoracic curve scoliosis is the most common type of scoliosis. It refers to a spinal curvature that occurs in the thoracic (upper/middle) area of the spine.
Scoliosis with a thoracolumbar curve refers to a curvature that occurs in the lower thoracic spine and the upper lumbar (lower) area of the spine.
Scoliosis with a lumbar curve revers to a curvature that occurs solely in the lumbar (lower) area of the spine.
Double Major Curve
Scoliosis with a double major curve refers to a spine that curves in two areas, with a curve occurring in the thoracic spine and another curve occurring in the opposite direction in the lumbar spine.
- Back pain
- Shoulder pain
- Tailbone pain
- Limited mobility
- Painful menstruation
- Respiratory difficulties
- Cardiac problems
- Uneven musculature on one side of the spine
- Uneven hips, arms or leg length
- Rib prominence
- Slow nerve action
Scoliosis is almost always diagnosed during childhood. It is often apparent in a physical exam and needs to be confirmed by an x-ray. A spinal x-ray can show the exact degree of the spinal curvature and whether the spine is in danger of interfering with internal organs.
For very mild cases of scoliosis, no treatment is necessary. The patient may be monitored over time to make sure that their scoliosis does not get worse into adulthood. In moderate to severe cases of scoliosis, treatment is often necessary. A conservative treatment option is for the child or teenager to wear a back brace while they continue to grow. The back brace is designed to encourage the spine to straighten itself out as the child grows into adulthood. If the spinal curvature is corrected once the child is fully grown, they no longer have to wear the back brace and the scoliosis is often permanently corrected. In very severe cases of scoliosis that cannot be corrected by a back brace, surgery is the only treatment. These cases typically involve scoliosis curvature measurements over 45 degrees. In these cases, the curvature of the spine is so extreme that the spine is impeding nearby internal organs and causing severe symptoms for the patient. Surgery to correct scoliosis involves a spinal surgeon using titanium rods and screws to fuse the spine into a straighter position.