Childhood Scoliosis

Scoliosis, which involves an abnormal lateral curvature of the spine, may be classified as congenital, idiopathic, or neuromuscular.

Childhood scoliosis is relatively uncommon, but is one of the most common congenital causes of back pain. Scoliosis is a lateral, or sideways, curvature of the vertebral spine. Often the cause of scoliosis is unknown, but it is not typically the result of an injury, as is the case with most other back problems. Often, scoliosis can be noticed by the naked eye, as you can often notice one arm or shoulder being higher than the other. With a patient's shirt off, one may also easily observe an abnormal sideways curvature of the spine while the patient is standing or bending forward. The most common diagnostic test to confirm a diagnosis, and to observe the severity of the condition, is through an X-ray of the spine. To observe the severity of the lateral curvature, the patient will either have PA (Posterior-Anterior) or AP (Anterior to Posterior) X-Ray projections taken. Many doctors and chiropractors will order standing X-Rays of the cervical/thoracic/lumbar/sacral spine due to the fact that the lateral curvature associated with scoliosis is more likely to become more exaggerated when the patient moves to the erect position. Often, the person may not experience any pain or limitations as a result of this condition, though people with more severe curvatures are more likely to experience back pain and associated symptoms. Typically, patients who aren't physically affected by scoliosis, in terms of symptoms, often don't require any treatment. Treatment options for scoliosis may vary based on the severity of the curvature, the age of onset of the condition, and the cause of the condition.

When the condition exists, the lateral curvature is often seen throughout the spine, as it takes on the shape of an "S" or a "C". The obvious signs of the condition, or onset of symptoms, may first present in early childhood, adolescence, or at any other type during adulthood. Typically, this condition will first present during childhood (childhood scoliosis) or later on in life, in elderly patients. Often, the condition is labeled idiopathic scoliosis (of no known cause), when the condition first presents in elderly men and women.

Signs and Symptoms: There is no exact science predicting which patients will experience symptoms as a direct result of the severity of their curvature. Two patients with the same type and degree of lateral curvature may have much different levels of overall comfort and physical ability. That being said, the worse the curvature, the more likely it will be that the patient does experience symptoms. The signs of this condition include:
  • Uneven height of the shoulders and hips, and the lengths of the legs.
  • When scoliosis occurs in the thoracic spine (chest area), the rotation of the rib cage may cause a prominence of one of the shoulder blades or one or more if the ribs.
  • One side of the spine may present with an uneven musculature.
  • Some patients will display slow nerve action.
Scoliosis can be classified into one of three categories, related to the cause, if known, of the condition:
  • Congenital Scoliosis: People with congenital scoliosis have an abnormal curvature when they are born, due to a genetic condition or problems that occur during the development of the fetus.
  • Idiopathic Scoliosis: Often the cause of the alteration of the spine away from its ideal architecture is not known. When the cause of the condition is unknown, the condition is classified as idiopathic scoliosis.
  • Neuromuscular Scoliosis. Neuromuscular scoliosis may have occurred because of a trauma/injury, or as the result of a neuromuscular condition. Neuromuscular diseases associated with scoliosis include spinal muscular atrophy, cerebral palsy, and spina bifida.