Scoliosis is a disorder wherein there is an abnormal curve of the spine or backbone. There is an abnormal lateral curvature of the spine which can cause your back to look sideways.
Pediatric Scoliosis is more often diagnosed in childhood and early adolescence. It can affect people of all ages, from infants to adults, but scoliosis is more common in children from 10 to 15 years old. Scoliosis affects about 2% of women and 0.5% on men.
Types of Scoliosis
- Infantile Idiopathic Scoliosis: for toddlers who are less than 3 years old
- Juvenile Idiopathic Scoliosis: for children between 3 to 10 years old
- Adolescent Idiopathic Scoliosis: for adolescents between 10 to 18 years old
Spinal Curvatures in Scoliosis
- Kyphoscoliosis: a combination of outward and lateral spine curvature. Kyphoscoliosis is a spine deformity that is characterized by an abnormal curvature of the vertebral column in the coronal and sagittal planes. It is a combination of kyphosis and scoliosis and can be associated with disorders such as Syringomyelia. Kyphoscoliosis can also cause pulmonary hypertension
- Dextroscoliosis: the curvature of the spine to the right. This is the most common type of scoliosis. It causes your spine to appear in “C” or an “S” shape instead of a straight line. It usually affects the thoracic region of the spine
- Rotoscoliosis: the curvature of the vertebral column turned on its axis. This is the term used to describe the worst and most severe type of scoliosis. Not only does the spine curve to the side, but the curve is also associated with a strong degree of rotation.
- Levoconvex Scoliosis: the curvature of the spine to the left. Also known as thoracic levoscoliosis, this type of scoliosis affects the thoracic region of your spine and it has an abnormal lateral curvature that goes to the left. This type of scoliosis can potentially affect your rib cage and could cause compression on your organs.
- Thoracolumbar Scoliosis: curvature related to both the thoracic and lumbar regions of the spine
Causes of Scoliosis:
What are the factors that cause scoliosis?
- Functional: Although the spine is normal, an abnormal curve develops because of a problem somewhere else in the body. One leg being shorter than the other or by muscle spasms in the back might cause this type of scoliosis.
- Neuromuscular: Upon the formation of the spine, some parts of the bone develops a problem. The bones of the spine could either fail to form completely or they fail to separate from each other during fetal development. This type of congenital scoliosis develops in people with other disorders, including birth defects, muscular dystrophy, cerebral palsy, or Marfan syndrome (an inherited connective tissue disease). People with these conditions often develop along the C-shaped curve and have weak muscles that are unable to hold them up straight. The congenital cause is when the curve is present at birth.
- Degenerative: This type of scoliosis occurs in adults. It is caused by changes in the spine due to arthritis known as spondylosis. The normal ligaments and other soft tissues of the spine tend to weaken and combined with abnormal bone spurs, this can lead to an abnormal curvature of the spine. Osteoporosis, vertebral compression fractures, and disc degeneration also affect the spine.
Symptoms of Scoliosis:
For mild scoliosis, the curve on the spine would not be that visible, but for severe scoliosis, symptoms would include:
- Uneven shoulders
- One shoulder blade that appears more prominent than the other
- Uneven waist
- One hip higher than the other
- Rotating and twisting spine
Risk Factors of Scoliosis:
- Age: Signs and symptoms usually start during the growth spurt that occurs just before puberty hits.
- Sex: Although both male and female develop mild scoliosis at about the same rate, women have a much higher risk of the curve worsening and requiring treatment compared to men.
- Family history: Scoliosis can run in families, however, most children with scoliosis don’t have a family history of the disease.
If left untreated, Scoliosis can cause complications including:
- Lung and heart damage: In severe scoliosis, the rib cage can press against the lungs and heart which will make it more difficult to breathe and the heart would be required to pump harder than normal.
- Back problems: Adults who had scoliosis as children are more likely to have developed chronic back pain than most people in general.
- Appearance: As scoliosis worsens, changes such as unlevel shoulders, prominent ribs, uneven hips, and a shift of the waist and trunk to the side would be more noticeable.
Scoliosis can be diagnosed and detected through the following tests:
- X-ray: Application of radiation to produce a film or picture of a part of the body can show the structure of the vertebrae and the outline of the joints. X-rays of the spine are obtained to search for other potential causes of pain, i.e. infections, fractures, deformities, etc.
- Computed tomography scan (CT or CAT scan): A diagnostic image created after a computer reads X-rays; can show the shape and size of the spinal canal, its contents and the structures around it. More detailed than an Xray.
- Magnetic resonance imaging (MRI): A diagnostic test that produces 3D images of body structures using powerful magnets and computer technology. It can show the spinal cord, nerve roots and surrounding areas, as well as enlargement, degeneration, and deformities.
Treatments of Scoliosis:
Scoliosis doesn’t usually go away especially if not treated. There are certain treatments that patients with scoliosis could do in order to manage their condition. Treatments would vary depending on the severity of the condition.
- Observation: Most children diagnosed and living with mild scoliosis do not require treatment. But, if the doctor can detect that the curve is increasing, he can examine the child every four to six months. Mild scoliosis treatment for adults is exercise but earing the prescribed brace is also recommended.
- Bracing: Braces are only for patients who have not reached skeletal maturity. If a child’s curve is between 25 and 40 degrees, scoliosis doctor will recommend a brace to prevent the curve from progressing. Braces used with full compliance has successfully stopped curve progression in about 80% of children. Braces should be checked regularly to ensure proper fit and may need to be worn 16 to 23 hours a day until the growth of the curve stops.
- Surgery: Surgery would only be recommended in children if the spinal curve is more than 40 degrees and signs of progression are present. In adults, The physician would usually recommend when their spinal curve is greater than 50 degrees and patients have experienced nerve damage to their leg/s and/or is experiencing bowel or bladder symptoms.
Frequently Asked Questions for Scoliosis
How to Manage Scoliosis Pain?
Primary problem caused by scoliosis is back pain. Painkillers and exercise may help reduce or relieve the pain. Scoliosis pain can also be irritating thus spinal injections must be considered.
For mild scoliosis pain management, Iit is often to do exercise, medical observation and scoliosis physical therapy. For some people, Yoga is also recommended to decrease pain level and increase flexibility.
What is Rotoscoliosis?
Rotoscoliosis is most often used to describe a severe form of scoliosis in which the spine not only curves to the side (as is normal with scoliosis), but the curvature is also associated with a strong degree of rotation.
What are the Early Signs of Scoliosis?
Children should be screened for scoliosis. Early signs include:
- Uneven shoulders or shoulder blades, with one higher than the other
- Uneven hips or waistline, with one higher than the other
If you are looking for scoliosis pain treatments, Dr. Ronak Patel is a scoliosis specialist in New Jersey. He can assess and help you manage your condition and help you find treatments that are suitable for you. He is also a back specialist who can help manage chronic back pains. To book an appointment, you can call him at his pain management clinic in New Jersey at 609-269-4451. Book now for a consultation before it’s too late!