Scoliosis is an abnormal curving of the spine. While all spines have a natural curve, patients with scoliosis have excessive spinal curving. Usually scoliosis develops during the growth spurt before puberty, between the ages of 9 and 15. Although some cases of scoliosis are congenital, and some are the result of underlying neuromuscular conditions, such as cerebral palsy or muscular dystrophy, most cases of scoliosis are idiopathic, meaning their cause is unknown. Both girls and boys can develop scoliosis, but cases in females are more likely to require treatment. In some cases, scoliosis appears to be hereditary.
Symptoms of Scoliosis
Patients with mild cases of scoliosis have no symptoms apart from the irregularity of their appearance. If the curve of the spine worsens, however, and the spine twists, patients may experience:
- Low back pain
- Extreme fatigue after sitting or standing
- Difficulty breathing (in severe cases)
If symptoms of scoliosis worsen, treatment may become necessary.
Diagnosis of Scoliosis
In addition to a physical examination of the back, shoulders, waist and hips, patients suspected of having scoliosis typically undergo neurological examinations to evaluate muscle strength, reflexes, and areas of numbness. Imaging tests are also administered to determine the severity of the problem and to rule out other possible reasons for the curvature of the spine, such as tumors. Diagnostic imaging tests may include CT, MRI and bone scans. A spinal curve measurement, using a device called a scoliometer, will also be taken.
Treatment of Scoliosis
Treatment of scoliosis varies a great deal depending on the severity of the condition.
Mild cases of scoliosis may require no treatment beyond periodic medical examinations. Cases of scoliosis affecting the following groups bear especially careful monitoring:
- Girls, who have a higher rate of progressive scoliosis
- Individuals with larger or double (S-shaped) curves
- Individuals whose abnormal curve is in the thoracic spine
Once patients have reached maturity, and their bones have stopped growing, as assessed by the onset of puberty and tests to assess bone growth, there is very little risk of worsening scoliosis.
Moderate to Severe Scoliosis
When treatment for moderate scoliosis is necessary, it most often takes the form of a back brace. While the brace will not cure the condition, it will prevent it from exacerbating. Braces for scoliosis are only used in children whose bones are still growing. More serious cases of scoliosis may require surgical intervention.
In most cases, the surgery performed to treat this condition is spinal fusion, during which two or more vertebrae are connected with bone grafts or artificial materials. During spinal fusion procedures, metal rods are installed to stabilize the area until the bones grow together. Although such surgery is normally done after the patient has finished growing, when the scoliosis is progressing at a dangerous rate, an adjustable rod may be inserted which can be lengthened every 6 months to accommodate the child's growth.
Most patients with scoliosis, even if it becomes severe, are able to be successfully treated and to lead normal, productive lives.