What is scoliosis?
spine has natural curves. These curves round our shoulders
and make our lower back curve slightly inward. But some people
have spines that also curve from side to side. Unlike poor
posture, these curves can’t be corrected simply by
learning to stand up straight.
This condition of side-to-side spinal curves is called scoliosis.
On an X-ray, the spine of a person with scoliosis looks more
like an “S” or
a “C” than a straight line. Some of the bones in a scoliotic spine
also may have rotated slightly, making the persons waist or shoulders appear
Curve of spine
Who gets scoliosis?
Scoliosis affects a small percentage of the population, approximately
2 percent. However, scoliosis runs in families. If someone in a
family has scoliosis, the Iikelihood of an incidence is much higher,
approximately 20 percent. If anyone in your farnily has curvature
of the spine, you should be examined for scoliosis.
- The vast majority
of scoliosis is “idiopathic’ meaning its cause is
unknown. It usually develops in middle or late childhood, before
puberty, and is seen more often in girls than boys.
- Although scoliosis
can occur in children with cerebral palsy, muscular dystrophy,
spina bifida and other miscellaneous conditions, rnost scoliosis
is found in otherwise healthy youngsters.
- Scoliosis usually
develops during childhood, but it also can occur in adults. Adult
scoliosis may represent the progression of a condition that actually
began in childhood, and was not diagnosed or treated while the
person was still growing. What might have started out as a slight
or moderate curvature has progressed in the absence of treatment.
- In other instances,
adult scoliosis can be caused by the degenerative changes of
- Other spinal deformities
such as kyphosis or round back are associated with the common
problem of osteoporosis (bone softening) involving the elderly.
As more and more people reach old age in the U.S., the incidence
of scoliosis and kyphosis is expected to increase.
- If allowed
to progress, in severe cases adult scoliosis can lead to chronic
severe pain, deformity, and difficulty in breathing.
The importance of early detection — tips for parents
Scoliosis is not preventable, but detection and treatment during
a child’s growing years is the best way to prevent an existing
problem from getting worse.
Idiopathic scoliosis can go unnoticed in a child because it is rarely painful
in the formative years. Therefore, parents should watch for the following “tip-offs’ to
scoliosis beginning when their child is about 8 years of age:
- uneven shoulders
- prominent shoulder blade or shoulder blades
- uneven waist
- elevated hips
- leaning to one side
Any one of these signs warrants an examination by the family
physician, pediatrician, or orthopaedist.
Some schools sponsor scoliosis screenings.
Although only a physician can accurately diagnose scoliosis,
school screenings can help alert parents to the presence of its
warning signs in their child.
In planning treatment for each child, an orthopaedist will carefully
consider a variety of factors, including the history of scoliosis
in the family, the age at which the curve began, the curve’s
location and severity of the curve.
Most spine curves in children with scoliosis will remain small and need only
to be watched by an orthopaedist for any sign of progression.
If a curve does progress, an orthopaedic brace can be used to
prevent it from getting worse. Children undergoing treatment with
orthopaedic braces in full- or part-time programs can continue
to participate in the full range of physical and social activities.
Electrical muscle stimulation, exercise prograrns, and manipulation
have not been found to be effective treatments for scoliosis.
If a scoliotic curve is severe when it is first seen, or if treatment
with a brace does not control the curve, surgery may be necessary.
In these cases, surgery bas been found to be a highly effective
and safe treatment.
Scoliosis is a common problem that usually requires only observation
with repeated examination in the growing years. Early detection
is important to make sure the curve does not progress.
In the relatively small number of cases that need medical intervention,
advances in modern orthopaedic techniques have made scoliosis a highly
manageable condition. Orthopaedists, specialists in diseases of the
muscles and skeleton, are the most knowledgeable and qualified group
of physicians to diagnose, monitor and treat this condition.
Your orthopaedist is a medical doctor with exiensive training in the diagnosis
and nonsurgical and surgical treatment of the musculoskeletal system, inciuding
honesjoints. liaments, tendons, muscles, and nerves.