Scoliosis (Spinal Curvature)

What is Scoliosis?

Scoliosis is defined as a curvature of the spine exceeding 10 degrees to the right or left, which should normally align straight when viewed from the back. Scoliosis is not just a one-dimensional angular deformity; it is a structural disorder that affects the body in three dimensions, from the front and side.

Types of Scoliosis

1. Idiopathic Scoliosis (Unknown Cause)

   • The most common type of scoliosis is adolescent idiopathic scoliosis, which has an unclear cause. The spine may curve into an 'S' or 'C' shape and can also rotate on its axis. This can lead to asymmetrical protrusions in the back or waist. It is more common in girls during adolescence.

2. Neuromuscular Scoliosis

   • This type of scoliosis is caused by underlying muscle and nerve diseases. It can result from conditions like cerebral palsy, polio, meningomyelocele, muscular dystrophy, or tethered cord syndrome. Unlike idiopathic scoliosis, it often includes respiratory difficulties and sensory defects.

3. Congenital Scoliosis

   • This is due to spinal anomalies that occur during fetal development. Congenital scoliosis usually progresses rapidly in the early years of life, often requiring early surgical intervention.

Scoliosis in Adults

1. Adult Idiopathic Scoliosis

   • This is a condition that may have started without symptoms in childhood but becomes noticeable in adulthood due to pain or posture issues. Degeneration of facet joints may cause severe pain, and severe spinal deformities can impact respiratory function.

2. Adult Degenerative Scoliosis

   • This type occurs due to the wear and tear of the spine with aging, typically seen in individuals over 50. It can also be exacerbated by osteoporosis. Symptoms may include back pain, leg pain due to nerve compression, and possibly spinal misalignment.

Symptoms of Scoliosis

Scoliosis symptoms include uneven shoulders, hip asymmetry, back or waist pain, and spinal rotation. It may also cause fatigue, rapid exhaustion, shortness of breath, and clothes not fitting properly. Regular monitoring is essential for early detection, especially in children aged 10-16.

Prevalence of Scoliosis

Scoliosis is a common spinal deformity worldwide, affecting 2-3% of the population. It typically appears during adolescence but can also develop due to congenital or acquired conditions. Early diagnosis and appropriate treatment are crucial for controlling the progression of scoliosis and improving the patient's quality of life.

Degrees of Scoliosis

• Mild Scoliosis (10-25 degrees): Usually monitored with regular check-ups and exercises.
• Moderate Scoliosis (25-40 degrees): May require a brace in addition to exercises.
• Severe Scoliosis (40-50 degrees): Typically treated with more aggressive methods such as physical therapy, bracing, and possibly surgery.
• Very Severe Scoliosis (over 50 degrees): Often requires surgical intervention due to the significant health risks.

Diagnosis and Treatment of Scoliosis

Diagnosis involves a detailed medical history, physical examination, and imaging techniques such as standing X-rays. Early detection is crucial, and regular monitoring of children's spines is recommended.

Treatment varies based on the severity and stage of scoliosis. Non-surgical treatments include observation, physical therapy, rehabilitation, and bracing. In severe cases, surgery may be necessary to correct and stabilize the spine.

Frequently Asked Questions

• Who is most likely to develop scoliosis?

  • Scoliosis can be associated with other conditions such as congenital spinal anomalies, muscle weakness, neuromuscular diseases, or spinal injuries.

• Does carrying heavy backpacks or poor posture cause scoliosis?

  • While these factors can negatively affect spinal health, they do not directly cause scoliosis, which is usually due to genetic or congenital factors.

• How is scoliosis treated in adults?

  • Treatment for adult scoliosis depends on symptoms' severity and the patient's overall health and may include physical therapy, exercise programs, pain management, or surgery.

• When is surgery necessary for scoliosis?

  • Surgery is considered when scoliosis is severe (Cobb angle above 40 degrees) or when non-surgical treatments fail to prevent progression or relieve symptoms.