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  • Scoliosis Sideways (Lateral) Curvature of the Spine

    There are various causes of scoliosis but in most cases, the cause is unknown. Most cases develop in children between the ages of 9 and 14 during the growth spurt of puberty. Most cases are mild and need no treatment. For more severe cases treatments include a back brace and surgery to straighten the spine.

    What is scoliosis?

    If you look at someone from behind, the spine should look straight up and down. If the spine has a sideways curve, it is called a scoliosis. The curve can bend to the left or to the right. The word scoliosis comes from the Greek word meaning crooked. The severity of the curve can vary from very mild and barely noticeable, to severe.

    The curve can be in the lower part of the spine (a lumbar curve), in the upper part of the spine (a thoracic curve), or go from the upper to lower part of the spine (a thoracolumbar curve). In some cases there is a double curve - like an S shape.

    What are the types and causes of scoliosis?

    Non-structural scoliosis (functional or postural scoliosis) In this type the spine is structurally normal, but looks curved because of another condition such as differing leg length, muscle spasm in the back muscles, etc. The curve is usually mild and it changes or goes away when the person bends sideways or forwards.

    Structural scoliosis In these cases the curve is fixed and doesn't go away when the person changes position. There are different types

     

    Idiopathic. This means the cause is not known. More than 8 in 10 cases of scoliosis are idiopathic.

    Neuromuscular. This means the curve is caused by a condition which affects muscles or nerves of the back. For example, it may occur in some cases of muscular dystrophy, polio, cerebral palsy, or neurofibromatosis. Each of these conditions has other symptoms and problems in addition to a scoliosis.

    Osteopathic. This means as a result of a bone abnormality.

    Congenital. This means the spine does not form properly when a baby develops in the womb.

     



  • In most cases the onset of the scoliosis is gradual and usually painless. Sometimes a mild to moderate scoliosis can develop without being noticed by the child or his or her parents. This is often because the condition usually develops at the age when children often become more self-conscious (age 9 to 14). Parents and others are not likely to see a naked back and see the problem.

    However, the more severe a scoliosis becomes, the more disfiguring it can become. This is because when the spine curves sideways, as the curve becomes more severe, the small bones that make up the spine (the vertebrae) also twist which pulls any attached muscles, ligaments and ribs, as a consequence:

    If the scoliosis is in the chest (thoracic) region the ribs and shoulder blade stick out like a bulge on one side of the back. The more severe the scoliosis, the larger the bulge. Also one shoulder may hang lower than the other, and one shoulder blade may be higher than the other.  If the scoliosis is in the lumbar (lower back) region it can make the pelvis thrust forward on one side and one leg may appear to be shorter than the other.

    If scoliosis becomes severe and is not treated, it can cause problems later in life. For example, persistent back pain may develop, and breathing problems or heart problems may develop if the deformity in the chest region is severe.

  • In some cases of scoliosis the diagnosis is obvious. However, some mild cases are not so obvious. A quick test which a biokineticist, doctor or nurse may do is simply to ask the child to bend forward. A bulge on the back of the chest is more obvious when bending forward. If a biokineticist, doctor or nurse diagnoses scoliosis you will normally be referred to a specialist.

     

  • Idiopathic scoliosis can develop at any stage in childhood. It is not known how or why it develops. It is not due to poor posture and you cannot prevent it.

    It most commonly develops during the growth spurt of puberty and early adolescence. It is quite common. About 1 in 20 children between the ages of 9 to 14 develop some degree of scoliosis. Most cases are mild and need conservative treatment whilst being checked from time to time.  About 4 in 1000 children develop scoliosis severe enough to need surgical treatment. Mild scoliosis affects about the same number of boys and girls. However, moderate or severe scoliosis is more common in girls.

    Idiopathic scoliosis is not a straightforward hereditary condition. However, there is some genetic factor in some cases. In about 1 in 4 cases there are one or more other family members with the same condition.