Spinal Scoliosis

Scoliosis is a sideways curvature of the spine, either into a "C" or an "S" shape. The most common type of scoliosis is adolescent idiopathic scoliosis, which develops in adolescents during their growth spurt, usually between ages 10 and 18. (Idiopathic means that the cause is unknown). Girls and boys are equally likely to develop mild scoliosis, but girls are far more likely to develop severe scoliosis.

Types of Scoliosis

Aside from idiopathic adolescent scoliosis, there are a number of different types of scoliosis. They include:

• Congenital scoliosis: Congenital scoliosis is a rare type of congenital malformation of the spine.
• Degenerative scoliosis: Adult (or degenerative) scoliosis can develop later in life, as joints in the spine degenerate.
• Infantile and juvenile scoliosis: Idiopathic scoliosis can also occur from birth to three years of age. This is called "infantile scoliosis." From three to nine years old, the condition is called "juvenile scoliosis."
• Neuromuscular scoliosis: Another type of spinal scoliosis is neuromuscular scoliosis, which is caused by conditions such as cerebral palsy and muscular dystrophy.

Symptoms of Scoliosis

Possible signs and symptoms of scoliosis include:

• An uneven waist
• One hip appears higher or more prominent than the other
• One leg appears shorter than the other
• One shoulder blade sticks out more than the other
• One shoulder is higher than the other
• One side of the rib cage appears higher than the other
• The body tilts to one side.

Take your child to a doctor if you notice any of these signs, as mild scoliosis is easier to treat than severe scoliosis. Scoliosis pain is rarely a symptom of mild to moderate scoliosis.

While most scoliosis is mild, severe scoliosis can be disabling. Severe scoliosis can cause back pain, difficulty breathing, and heart and lung damage.

Treatment for Scoliosis

Treatment for scoliosis is based on a number of factors:

• Bone maturity: If a child's bones have stopped growing, the curve is unlikely to get worse.
• Curve pattern: Double (S-shaped) curves tend to worsen more often than C-shaped curves.
• Degree of curvature: Larger curves are more likely to worsen with time.
• Gender: Scoliosis in girls is much more likely to worsen than in boys.
• Location of curve: Curves located in the center section of the spine worsen more often than curves in the upper or lower spine.

Back braces are most commonly used if a child has moderate scoliosis and the child's bones are still growing. A brace doesn't cure scoliosis, or reverse the curve, but it usually prevents the curve from getting worse.

For severe scoliosis, scoliosis surgery (spinal fusion) reduces the severity of the spinal curve and prevents it from getting worse.

Degenerative Adult Scoliosis

Usually, degenerative scoliosis is first noticed as lower back pain, although the pain is probably not coming from the curve but from the degeneration in the spine that is causing the curve. Treatments include medications, exercise and braces to support the spine. If you have worsening nerve problems or uncontrollable pain, surgery is an option.

Resources

American Academy of Orthopaedic Surgeons Staff. (n.d.). Idiopathic scoliosis in children and adolescents. Retrieved March 12, 2010, from http://orthoinfo.aaos.org/topic.cfm?topic=A00353

Mayo Clinic Staff. (n.d.). Scoliosis. Retrieved March 12, 2010, from http://www.mayoclinic.com/health/scoliosis/DS00194

Ullrich, P., MD. (n.d.). Scoliosis treatment. Retrieved March 12, 2010, from http://www.spine-health.com/conditions/scoliosis/scoliosis-treatment

Blackman, R., MD et al. (n.d.). Scoliosis: Curvature of the spine and surgical treatment of this disorder. Retrieved March 12, 2010, from http://www.spineuniverse.com/conditions/scoliosis/scoliosis-curvature-spine-surgical-treatment-0

University of Maryland Spine Program. (n.d.). A patient's guide to degenerative adult scoliosis. Retrieved March 12, 2010, from http://www.umm.edu/spinecenter/education/degenerative_adult_scoliosis.htm