Scoliosis is a curvature in the vertical line of the spine. When viewed from the front, normal spines appear to be straight. With scoliosis the spine appears to be curved. There are many types and causes of scoliosis including neuromuscular scoliosis, congenital scoliosis, idiopathic scoliosis and degenerative scoliosis. Almost one in one hundred people in the general population have some type of scoliosis. Most of these case are very mild and only ten out of one hundred children with scoliosis require bracing or surgery.
Approximately 3% of Americans at age 16 have scoliosis. However less than 0.1% of these teens appear to have spinal curves calculating more than 40 degrees. This is the stage when surgery becomes necessary. Girls are more likely to be affected than boys. Scoliosis progresses during the growth spurt years, but does not progress during adulthood.
Congenital scoliosis is caused by the spine growing abnormally at birth. Neuromuscular scoliosis is the consequence of atypical nerves and/or muscles growing around the spine. This type of scoliosis is seen in patients with cerebral palsy or spina bifida. Degenerative scoliosis results from a traumatic injury of illness, bone collapse or major back surgery. Thinning of the bone or osteoporosis can also cause scoliosis. Idiopathic scoliosis is the most common type. It has no specific cause but it is almost assumed that idiopathic scoliosis is inherited.
Most scoliosis problems are detected on school screening exams, by a pediatrician or doctor or even by a parent. Clues that your child may have scoliosis includes uneven shoulders, a prominent shoulder blade and an uneven waist. Once you suspect scoliosis, a careful bone exam and X-rays evaluate the magnitude.
If your teen has significant scoliosis with no known cause, they will be checked every four to six month and include a physical exam and low radiation X-ray. Treatments can include braces. If adolescents have a spinal curve between 25 degrees to 40 degrees and if their bones are still maturing or if they have a least two years of growth remaining, they will be braced. Bracing is designed to halt progression of the curve. It will provide temporary correction, but if bracing is eliminated too soon the curvature will return.
Surgery can be an option for those who have spinal curves beyond 40 degrees. The purpose is to ensure that the curve does not get worse. Surgery cannot perfectly straighten the spine, but it is an option. During the surgery, metallic implants are used to correct the curvature and hold it in the correct position. At the time of surgery a bone graft is placed around the spine to consolidate and create a rigid fusion in the curved areas. Scoliosis can also involve joining the vertebrae together permanently. This is called spinal fusion.
It was once thought that electrical stimulation, exercise and manipulation would prevent the progression of scoliosis. There is absolutely no benefit to these programs, but if you do have scoliosis you still need to stay active and fit.
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