Scoliosis is a disorder of the spine that can affect many individuals, but is commonly seen in females and occurs often during the growth spurt just before puberty. The symptoms of scoliosis might be mild, but in severe cases the symptoms can be life-threatening. Coping with scoliosis is difficult for a young person in an already complicated stage of life.
What is Scoliosis?
Scoliosis is a sideways curvature of the spine. While scoliosis can be caused by conditions such as cerebral palsy and muscular dystrophy the cause of most scoliosis is unknown.
Most cases of scoliosis are mild, but some children develop spine deformities that continue to get more severe as they grow. Severe scoliosis can be disabling. An especially severe spinal curve can reduce the amount of space within the chest, making it difficult for the lungs and heart to function properly.
Children who have mild scoliosis are monitored closely, usually with X-rays, to see if the curve is getting worse. In many cases, no treatment is necessary. Some children will need to wear a brace to stop the curve from worsening. Others may need surgery to keep the scoliosis from worsening and to straighten severe cases of scoliosis.
What are the symptoms of Scoliosis?
Signs and symptoms can vary from one individual to another. Symptoms would also depend on the degree of curvature of the spine.
Signs and symptoms of scoliosis may include the following:
• Uneven shoulders
• One shoulder blade that appears more prominent than the other
• Uneven waist
• One hip higher than the other
• Back pain
• Difficulty breathing
If a scoliosis curve gets worse, the spine will also rotate or twist, in addition to curving side to side. This causes the ribs on one side of the body to stick out further than on the other side.
What causes Scoliosis?
We do not know what causes the most common type of scoliosis, although it appears to involve hereditary factors because the disorder tends to run in families. Less common types of scoliosis may be caused by:
• Neuromuscular conditions such as cerebral palsy or muscular dystrophy
• Birth defects affecting the development of the bones of the spine
• Injuries to or infections of the spine
Complications of Scoliosis
While most people with scoliosis have a mild form of the disorder, scoliosis may sometimes cause complications, including:
• Lung and heart damage. In severe scoliosis, the rib cage may press against the lungs and heart making it more difficult to breathe and harder for the heart to pump.
• Back problems. Adults who had scoliosis as children are more likely to have chronic back pain than are people in the general population.
• Appearance. As scoliosis worsens, it can cause more noticeable changes — including unleveled shoulders, prominent ribs, uneven hips, and a shift of the waist and trunk to the side. Individuals with scoliosis often become self-conscious about their appearance.
Diagnosis
During your visit to the doctor a detailed history and examination will be performed. The diagnosis can usually be made during this visit.
Plain X-rays can confirm the diagnosis of scoliosis and reveal the severity of the spinal curvature. If a doctor suspects that an underlying condition — such as a tumour — is causing the scoliosis, he or she may recommend additional imaging tests.
Treatment
Most children with scoliosis have mild curves and probably would not need treatment with a brace or surgery. Children who have mild scoliosis may need checkups every four to six months to see if there have been changes in the curvature of their spines.
Questions remain about the best treatment. While bracing has been used for decades, it does not work for everyone. Researchers are currently trying to identify when wearing a brace is effective. Meanwhile, new surgical techniques that don’t require fusing are being developed to gradually straighten the spine as it grows.
It is also unclear when curvature caused by scoliosis is likely to get worse. Girls tend to be at higher risk for this than boys, as are children who begin to develop scoliosis at a very young age. Some doctors are using a new genetic test to determine who is most likely to see the condition worsen.
A new technique called tethering is currently being used to treat scoliosis.
There are treatment guidelines for mild, moderate and severe curves. the decision to begin treatment is always made on an individual basis.
Various clinical studies indicate that chiropractic manipulation, electrical stimulation of muscles and biofeedback treatments are ineffective treatments for scoliosis.
Conclusion
Scoliosis is a disorder of the spine. Some curves in the spine are normal, but large curves from side to side in the shape of the letter “S”, or the letter “C”, can cause symptoms some of which can be very severe. Most cases of scoliosis are mild and if found early can usually be prevented from getting worse. Treatment options are available, but not all cases require treatment. If you or your child has signs suggestive of scoliosis you should seek medical advice.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. Dr Brett Hodge is an Obstetrician/Gynaecologist and Family Doctor who has over twenty eight years in clinical practice. Dr Hodge has a medical practice in the Johnson Building in The Valley.
