Scoliosis
Children will often be checked for scoliosis at school, but a doctor's examination may be necessary for a full diagnosis.
Scoliosis is a condition in which the spine, or backbone, becomes overly curved to the side. Your spine is comprised of small bones called vertebrae, which are normally stacked on top of each other to form a straight column. When viewed from the front or behind, this arrangement creates the perfect foundation of support for the body. Vertebrae are grouped according to their location:
- cervical - neck
- thoracic - midback
- lumbar - lower back
Scoliosis causes a sideways bend to develop in the vertebrae of the thoracic and lumbar regions. As a result, the spine appears "S-shaped" when viewed from the back.
Scoliosis usually becomes evident in adolescence, when the body undergoes a growth spurt, and is found more commonly in females.
Causes
In most cases, the cause of scoliosis is not known. For others, the condition can be linked to:
- genetic or birth defects
- postural anomalies
- leg length differences
- the aging process
- diseases such as muscular dystrophy
- tumors or other abnormalities in the spine.
Symptoms
The symptoms of scoliosis range from subtle postural changes to severe curvature of the spine. Signs of scoliosis may include:
- uneven shoulders
- uneven hips
- sunken chest
- rib cage turned to one side
- protruding shoulder blade
- swayback
- leaning to a preferred side when sitting and standing
- poor sitting/standing endurance
- low back pain
- muscle weakness
- difficulty breathing (in severe cases).
Diagnosis
A screening for scoliosis can be completed to check for signs of the condition. These examinations are frequently completed in school settings by a nurse. The check-up includes the forward bend test, in which the person stands with the feet and knees together and bends forward to touch the toes. If the spine appears curved or seems to have a "hump," referral to an orthopaedic surgeon or pediatrician will be recommended.
Your doctor will complete a more in-depth examination of your spine. X-rays may also be used to identify asymmetry in the spinal column. Diagnosis is based on the location, direction and amount of the curve (measured in degrees). Some curvature of the spine is natural and should not be considered a problem. Scoliosis is defined as a curve of the spine measuring 10 degrees or more.
Treatment
Treatment for scoliosis will vary according to the extent of the condition and your age, which is important in determining future bone growth and possible complications relating to scoliosis. Treatment is usually prescribed if curvature of the spine is 30 degrees or greater. Conservative options may include:
- wearing a trunk brace for support and to prevent further deformity
- wearing an orthotic device, such as a heel lift, to correct postural alignment
- anti-inflammatory medications for back pain
- physical therapy to learn proper body mechanics and exercises to strengthen the back and trunk.
Surgical treatment may be needed in severe cases. An orthopaedic surgeon will carry out the procedure, which usually involves placement of a metal rod in the spinal column for support prevention of further curvature. A spinal fusion may also be performed, in which some of the vertebrae are permanently joined together, forcing them not to move, to attempt to prevent progression of the curve.
Complications
If diagnosed early, scoliosis can be treated with good results, however serious cases can lead to lung and heart conditions. For surgical patients, the risks of operative treatment include infection, blood loss, paralysis and loss of fixation. Talk with your doctor regarding your condition and probable outcomes with available treatments.