From the back, a normal human spine looks straight. With scoliosis, there is a noticeable curve to one side or the other that resembles the letter S or perhaps a C shape. One shoulder or hip may also appear higher than the other, and the spine sometimes twists as well, causing the ribs to protrude on one side of the body. Back pain and breathing trouble can also occur with severe scoliosis.
Causes of Scoliosis
Idiopathic scoliosis, the most common type, has no identifiable cause. Evidence suggests that it’s hereditary since there is an increased chance of development when another family member has the condition. Scoliosis occurs most often in adolescence around the growth spurts of puberty, and while girls and boys both develop it, the severity of the condition tends to progress more frequently in girls.
Other types of scoliosis are less common. Congenital scoliosis occurs due to abnormal bone development and is detectable at birth. Neuromuscular scoliosis is caused by medical conditions such as polio, muscular dystrophy, cerebral palsy and spina bifida. Degenerative scoliosis can result from various conditions or events, including osteoporosis, significant back surgery, spinal infections, traumatic injuries or paralysis.
Slowing or halting the progression of scoliosis is the primary goal when treating children and adolescents. Mild idiopathic cases usually only require periodic exams to monitor possible progression.
When a child is over the age of 10 but his or her bones have not stopped growing, back braces are effective in halting idiopathic progression. The type of brace used depends on age and gender as well as the shape, location and severity of the curve. Braces are most effective when they’re worn day and night, but they can be removed for specific activities. This treatment is less effective once an adolescent’s bones stop growing, and a doctor may choose to discontinue it. While braces can stop curvatures from worsening, they cannot cure scoliosis.
Braces are not effective with congenital or neuromuscular scoliosis; however, surgery can sometimes make improvements. This treatment is also a possibility for severe idiopathic and degenerative conditions. Ideally, surgery is postponed until after bone growth is complete, yet delays may not be possible in severe cases. The most common procedure, called spinal fusion, joins spinal bones together. Metal rods support the spine while bone grafts grow into and fuse the vertebrae. When growing children have spinal-fusion surgery, adjustable, expandable rods allow normal growth to occur; these children usually wear back braces as well.
Studies have not shown that alternative treatments can prevent scoliosis progression; however, pain management centers offer options such as electrical stimulation and epidural steroid injections to help patients deal with associated pain. Acupuncture, chiropractic manipulation, biofeedback and medications can also assist, and physical therapy can be helpful when adjusting to a brace or recovering from surgery.
Summary and Conclusion
Scoliosis is a condition that curves and sometimes twists the spine into abnormal shapes. It can be mild to severe and may or may not progress. Adolescent girls and those with a family history of scoliosis have the highest risk for the disorder. Various congenital, neuromuscular and degenerative conditions also cause scoliosis. Back braces and surgery are most effective at halting progression. Pain management through medication and alternative therapies can help improve overall functionality and quality of life.