Scoliosis：Types, Symptoms and Treatment

Overview

Scoliosis is an abnormal curve in the spine that occurs commonly in late childhood and the early teens before puberty. Scoliosis causes a sideways curve of the backbone, or spine. These curves are often S- or C-shaped. A side-to-side curve in the spine led by scoliosis measures 10 degrees or more on an X-ray.

Girls are more likely to suffer from scoliosis than boys. It can pass along in families. Although scoliosis is generally associated with children, adults can have it too when it is not detected during childhood or the disease becomes aggressive. Most cases of scoliosis are mild, but severe scoliosis, if any, can cause disability.

Types of Scoliosis

There are two general categories of scoliosis:

• Structural scoliosis

It is the most common category of scoliosis, involving spinal rotation and the side-to-side curvature of the spine. This type of scoliosis will affect the structure of the spine and is considered permanent unless the spine receives treatment.

• Nonstructural scoliosis

It is also known as functional scoliosis, resulting from a temporary cause. It is only a side-to-side curvature of the spine and the spine’s structure is still normal.

Structural Scoliosis is generally considered more serious because it does not straighten out on its own and potentially results in more spinal deformity. The following are four types of Structural Scoliosis:

• Idiopathic scoliosis

There are about 8 Idiopathic scoliosis in 10 cases of general scoliosis. This type of scoliosis usually occurs during adolescence, but it can also start earlier from childhood or infancy. The cause of idiopathic scoliosis is by far unknown. Some research indicates that genes play a part in it, but other factors may also work. Further studies are needed.

• Degenerative scoliosis

Adult scoliosis is a common condition that occurs later in life as the joints in the spine degenerate.

• Neuromuscular scoliosis

It sometimes occurs among people who are unable to walk due to a neuromuscular condition such as muscular dystrophy or cerebral palsy. It is also called myopathic scoliosis.

• Congenital scoliosis

It develops in the womb and presents in infancy. It is a rare condition that affects 1 in 10,000. It can be caused by malformations in the vertebrae or other factors. In most cases, the spinal curve must be erected by having surgery.

Symptoms

When a sideways or spinal curvature of at least 10 degrees is measured on an X-ray of the spine, it is considered scoliosis. If the curve progresses to 20 degrees or beyond, there is an increasing chance of abnormalities. The change in the curve of the spine typically occurs very slowly so it is easy to miss until it becomes a more severe physical deformity.

In most cases, scoliosis is not painful, but there are certain types of scoliosis that can cause back pain, rib pain, neck pain, muscle spasms, and abdominal pain. Other common signs and symptoms include:

• Uneven shoulders or waist

• One shoulder blade that appears more prominent than the other

• Difference in the shoulder and hip height

• Difference in the way the arms hang beside the body when standing straight

• Weakness or numbness in one or both legs

Causes

Although non-structural scoliosis is relatively uncommon, there are some ways it can occur:

• Muscle spasms

If you feel a spasm in the major muscle in the back, the spine could be pulled in one direction and result in a sideways curve.

• Inflammation

If an area of the spine in the body starts to become inflamed, it can also lead to a scoliosis curve. Some possible causes could be appendicitis or pneumonia.

• Difference in leg heights

If one leg is obviously longer than the other, a scoliosis curve may be present while standing.

Other risk factors for developing the most common type of scoliosis include:

• Age

It is a risk factor as the symptoms often begin between 9-15 years of age. Signs and symptoms typically begin during the growth spurt that occurs just before puberty.

• Sex

According to research, scoliosis affects about 2% of females and 0.5% of males. Females are more prone to suffer from scoliosis and have a much higher risk of the spine curvature worsening than males.

• Family history

Scoliosis can run in families. Although many individuals who develop the problem do not have family members with scoliosis, a family history of scoliosis increases the risk of the disease.

Diagnosis

When there is any abnormality in your spine, seeking help to a doctor for further checkups and advice is recommendable. The doctor will first get to know a detailed medical history and may ask questions about recent growth. To confirm and diagnose scoliosis, you may be ordered to take the following imaging tests to see the complete spine from the skull to the pelvis:

• X-Ray–It provides detailed pictures of bones of the spine to confirm the diagnosis of scoliosis and reveal the severity of the spinal curvature. Upright and dynamic X-rays, which show the spine in motion, are the best way to assess the alignment and stability of the spine.

• Magnetic resonance (MR) imaging–It uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body and to further confirm whether there is an underlying condition–such as a tumor.

• Computed tomography (CT) scan–It uses a combination of X-rays and computer technology to produce detailed images of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.

Treatment

Treatment of scoliosis depends on the severity of the curve and the chances of the curve getting worse. People with mild symptoms of scoliosis might only need checkups to observe and manage the curve. Others might need to wear a brace or more severely, have surgery.

Bracing is a common treatment option for scoliosis without having spine surgery. The most common type of brace is made of plastic and is personally designed to conform to the body. This close-fitting brace is nearly invisible under the clothes, since it places exactly under the arms and around the rib cage, lower back and hips. Wearing such a brace may not cure scoliosis or reverse the curve, but it can usually prevent further aggravation of the curve.

However, when the curve is too severe and bracing doesn’t work enough, having surgery may be the best option to correct the curve. Severe scoliosis will typically progress over time, so the doctor might suggest scoliosis surgery to alleviate the severity of the spinal curve and to prevent it from getting worse. The most common type of scoliosis surgery is spinal fusion.

If the scoliosis is deteriorating rapidly at a young age, surgeons can install a rod which can adjust in length as the child grows. This growing rod is attached to the top and bottom sections of the spinal curvature and is usually lengthened every six months.

Of course, there are some complications of spinal surgery, including bleeding, infection, pain or nerve damage. Rarely, the bone fails to heal and causes more serious spinal problems.

The decision making and surgical planning for treatment of scoliosis are complex. Therefore, it is advisable to ask a doctor for correct treatment procedures.

Keywords: scoliosis.

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