Scoliosis is a health condition that involves sideways curvature of the spine, usually resulting in an “S” or “C” shaped curve in the back that is evident on an X-ray.
The term derives from the Greek work skoliosis, which means crooked, as a result of the altered shape of the spine that is characteristic of the condition.
It usually develops in children in the growth spurt prior to puberty, between the ages of 9 and 14. However, it can also be present from birth or arise due to related health conditions that affect the individual, such as cerebral palsy and muscular dystrophy.
Most individuals with scoliosis have mild effects that do not impact greatly on daily life and activities. However, in severe cases the condition can have disabling effects, particularly if the spinal curvature inhibits the pulmonary cavity and ability to breathe easily.
Children with scoliosis should be monitored closely as they grow, to allow early intervention if the spinal curvature worsens. This is usually carried out with the use of X-rays to view the bone development. While many children will not need any treatment, some children will require a brace to prevent curvature worsening and others will need surgery to prevent or correct the curve.
Most children with scoliosis do not complain of any pain as a result of scoliosis. In the majority of cases, the initial sign of the disease is visual changes of the back and asymmetry of the body.
For adults with the disease, however, back pain can become a more prominent issue. The cosmetic view of the spine and back can also be worrying for some individuals and may lead to social anxiety and other mental health issues.
Scoliosis can be classified according to the likely cause and by the curvature of the spine.
The causes may include:
- Congenital: vertebral anomalies at birth
- Idiopathic: unknown cause that may have presented in infancy, childhood, adolescence or adulthood
- Neuromuscular: secondary to a related health condition such as spina bifida, cerebral palsy, spinal muscular atrophy or other physical trauma
The convexity or direction of the spinal column may be:
- Dextroscoliosis: convexity of spine on the right side of body
- Levoscoliosis: convexity of spine on the left side of body
There are three main methods of treatment of scoliosis: observation, bracing and surgery.
In the initial stages of the disease, the best course of action is to use X-ray imaging every four to six months to view the changes in the spinal curvature. This is because many individuals will not need any intervention, but early initiation of treatment is beneficial for those that do.
A brace can be used to foster bone health and improve straight growth of the spine. This should be worn at all times, except when showering or having a bath, which usually equates to at least 23 hours per day. Many children that use a cast will result in sufficient support to prevent worsening of the spinal curvature, but some may require corrective surgery.
Surgery is helpful to improve bone growth and to correct severe spinal curves that may lead to cardiopulmonary complications. Growth rods can be inserted for younger children to guide the growth of the spine throughout childhood and adolescence. When the individual can finished growing, at approximately the age of 17, corrective spinal fusion therapy can be carried out to straighten out the spine when the degree of curvature is significant.