Scoliosis is a sideways curvature of the spine. Scoliosis is a pathological lateral curvature of the spine, as opposed to the natural vertical curves of the spine (cervical, thoracic, lumbar, sacral). The presence of scoliosis may come to the attention of parents of physical education teachers who notice one shoulder being higher than the other, or an obvious abnormal lateral curvature of the spine. The presence of scoliosis could be confirmed by X-Ray radiography of a person standing up, with their arms by their side. If a person were to test negative for scoliosis, a standing X-Ray image would show a straight spine in proper alignment. A positive finding would show a lateral curvature of the spine. Physical symptoms may or may not be associated with scoliosis, including back pain or neck pain. Scoliosis will usually be discovered during childhood or adolescence, and the prognosis is good for individuals that are properly treated for the condition. Usually, conservative treatments such as bracing (back bracing) and/or physical therapy will be successful at treating this condition. When conservative therapies have resulted in unsuccessful treatment, then spinal fusion surgery may be considered. Surgery for this condition is rare, and only two percent of people with scoliosis require any treatment at all.
The cause of scoliosis may be due to congenital pre-disposition (it runs in families) or due to environmental stressors. There are four types of scoliosis:
- congenital (poor fetal development)
- neuromuscular (disease)
- traumatic (accident or injury)
- idiopathic (unknown cause)
Congenital scoliosis is present at birth, due to poor fetal development of the ribs and spinal vertebrae. There are many neurologic and musculoskeletal conditions that fall under the umbrella term of neuromuscular scoliosis. Neuromuscular scoliosis is the result of disease that that affects the musculoskeletal or neurologic system: such as cerebral palsy. Traumatic scoliosis is the result of an accident or trauma to your spine. An injury to the muscles or soft tissues of your spine, side effects from radiation treatments, or spinal fracture. The majority of cases (70-80%) of scoliosis, though, occur due to idiopathic scoliosis.
Idiopathic means that there is no known cause of the disease. The patient's scoliosis may be labeled as idiopathic is the precise cause is unknown even after extensive testing and medical imaging. Though the exact mechanism of idiopathic scoliosis is unknown, we do know that it usually develops in adolescence, and severe cases occur most often girls. In children with idiopathic scoliosis, the spine is normal at birth and starts to curve just before or during the adolescent growth spurt. Boys and girls are represented in equal numbers, though severe cases occur more often in girls. In the cases of adolescent onset scoliosis, the abnormal curvature will usually increase until the person stops growing, but not always. A significant number of these individuals with childhood idiopathic scoliosis may have a gradual worsening of their curves even after their growth ends. If the worsening of their spinal curves continues past the beginning of adulthood, they may experience reduced mobility, stiffness, and pain and disability. If you were diagnosed with mild to moderate scoliosis as in early adolescence or teen years, it will be a important to have your back checked once a year to monitor for improvements or worsening.