Scoliosis refers to an abnormal curve in the spine that frequently develops during childhood or adolescence. The sideways curvature can affect a person’s appearance and in severe cases, impact lung and heart function. Because the condition can lead to self-consciousness about one’s appearance and create the potential for health concerns, treatment is typically recommended while the patient is still young when possible.
Scoliosis
Scoliosis: An Overview
From behind, the healthy spine looks like a straight line running vertically through the torso. In profile, the healthy spine has three natural curves at the neck, upper back and lower back that resemble a loose ‘S’ shape.
A spine with scoliosis has abnormal curvature — often appearing like the letters ‘S’ or ‘C’ — with a rotation of the vertebrae. Viewed from the rear, this curvature creates the appearance that the person is bent or leaning to one side. Spinal curvature from scoliosis may occur in the thoracic (mid) or lumbar (lower) sections of the spine and on the right or left side of the spine.
Scoliosis can vary significantly in severity. Mild cases may go completely undetected, while more severe cases may be debilitating. For children and teens with noticeable scoliosis, there are treatment options to help stop the curvature from worsening and even reverse it in some cases. If you or someone else notices signs that could indicate scoliosis in your child, an appointment with us will help you obtain an early diagnosis and treatment before the curvature becomes more substantial.
Types of Scoliosis
Scoliosis is categorized as congenital, idiopathic or neuromuscular.
Congenital scoliosis
Congenital scoliosis is present at birth and results from the malformation of one or more vertebrae in any location of the spine. The diagnosis may be made in early infancy if visible signs are present, but many cases are diagnosed later in childhood.
Idiopathic scoliosis
Idiopathic scoliosis has no known cause. Most cases of idiopathic scoliosis develop between the beginning of adolescence (around age 10) and the time a child is fully grown. The condition may be called infantile idiopathic scoliosis, juvenile idiopathic scoliosis or adolescent idiopathic scoliosis depending on the age of onset.
Neuromuscular scoliosis
Neuromuscular scoliosis refers to scoliosis that accompanies a neurological or muscular disease, such as cerebral palsy, spina bifida, muscular dystrophy or spinal cord trauma. These types of neuromuscular conditions can cause weakness and imbalance in the muscles that support the spine.
Signs and Symptoms
Some of the signs and symptoms of scoliosis may include:
- One shoulder is higher or more prominent than the other
- The head is not centered directly above the pelvis
- The waistline is not even
- One hip sits higher than the other
- One side of the ribcage is more prominent when the patient bends over
- The patient looks like they are leaning when standing up straight
- The arms do not hang evenly beside the body when the patient is standing straight
The symptoms of scoliosis can resemble other spinal conditions or deformities. Always consult a reputable orthopedic physician for a diagnosis.
Diagnostic Methods
Scoliosis is usually confirmed through a medical history and physical examination. The history may include questions about family history of scoliosis, presence and location of pain (if any), curve progression, and any other signs or symptoms the patient has noticed. In the physical examination, the physician visually inspects the shape of the spine and observes how the patient moves around.
Doctors may detect scoliosis from what is known as the “Adam’s forward bend test.” When the patient bends over, it is much easier for a physician to tell if the spine is straight or if there is a slight sideways curve.
This is a simple initial screening test that can identify potential issues but cannot determine the exact type or severity of the deformity.
Imaging tests may be used to finalize the diagnosis and assess the severity of the curve. Some of the imaging tests used at the Orthopaedic Institute of Ohio include x-ray, CT scan and MRI.
Causes of Scoliosis
There are a few causes associated with scoliosis:
- Neuromuscular conditions like muscular dystrophy or cerebral palsy
- Injuries or infections in the spine that lead to abnormal growth
- Congenital disabilities that impact the development and growth of the spine
- Spinal cord abnormalities
Most cases of scoliosis do not have an identifiable cause. It is most commonly diagnosed at the beginning of puberty or during adolescence. While there may be a genetic factor, most children diagnosed with scoliosis do not have a family member with the condition. Scoliosis occurs among boys and girls at approximately the same rate. However, girls have a significantly higher risk of spinal curvature worsening and requiring treatment.
Treatment Options for Scoliosis
The appropriate treatment option for scoliosis is based on a combination of factors, including spinal maturity, the location of the curve, the degree and extent of curvature, the patient’s quality of life and the possibility of curve progression.
Mild cases of scoliosis may only require watchful waiting, to ensure the curvature does not worsen. If the curve is moderate or changes over time, a brace may be recommended for a period to prevent further progression. Bracing is only effective in patients who have not reached skeletal maturity. On average, boys complete their growth around age 16 and girls around age 14, but this varies by individual.
Severe cases of scoliosis, including those that affect heart and lung function, may require surgical correction to straighten the spine and eliminate related complications. Various surgical techniques are used, including:
- Spinal fusion
- Expanding rod
- Vertebral body tethering
Physicians are most likely to consider surgery as a treatment option for a child with severe scoliosis or a curve that exceeds 40-50 degrees. Some adults who were treated for scoliosis as children may need revision surgery.
Visit the Orthopaedic Institute of Ohio
At the Orthopaedic Institute of Ohio, the brightest minds in orthopedic care collaborate to create a treatment plan tailored to you. Our board-certified physicians, physician assistants, nurse practitioners, physical therapists and other healthcare professionals work together to help you optimize your quality of life and maintain long-term spinal health.
Contact the Orthopaedic Institute of Ohio today at 419-963-4870 to schedule your consultation.