Index
It is a medical condition in which the spine curves to one side of the body rather than straight.
Many people have scoliosis, and it can be mild to severe.
A doctor can usually make an initial diagnosis during a routine exam, where he will feel the path of the spine.
2-3% of people have been diagnosed with scoliosis by 16, and girls are more likely to have it than boys.
Causes of scoliosis
There are two types of scoliosis: “structural” and “nonstructural” scoliosis.
- Structural scoliosis refers to a curve in the spine that is irreversibly rigid.
- Nonstructural scoliosis refers to scoliosis secondary to other problems, such as irregular leg length, muscular dystrophy, and more.
There are several causes why the curves of the spine are abnormal and cannot grow straight, such as:
Genetics certainly plays a role, and babies born with the signs of scoliosis are “congenital” cases, but the root cause is still unknown. A congenital or birth-related defect could cause the curvature.
The bones may not have grown or developed correctly. In many cases, such as idiopathic scoliosis, there is no definite cause or way to prevent the spine from developing the right way.
Some babies are born with spinal problems that cause the spine to grow unevenly. These include congenital scoliosis, kyphosis, spina bifida, or Klippel-Feil anomaly.
Other medical conditions that affect the nerves or muscles could affect the spine.
Some children have nerve or muscle (neuromuscular) diseases, injuries, or other diseases that cause spinal deformities, such as cerebral palsy, spina bifida, or muscular dystrophy.
Under these conditions, the muscle abnormalities combined with the child’s growth result in deformity. Cases of neuromuscular scoliosis are due to spina bifida or cerebral palsy and can lead to complete paralysis.
An injury, previous surgery, or osteoporosis can cause the spine to change shape. This is known as degenerative scoliosis.
- Bone dysplasias: Many generalized abnormalities of bone formation are associated with scoliosis. Slight differences in leg length can cause slight curvature but rarely cause severe curvature.
- Connective tissue disorders: Conditions with abnormal tissues and ligaments, such as Marfan syndrome and Ehlers-Danlos syndrome.
- Spinal cord injury with paralysis.
- Some infections
- Presence of tumors.
Your doctor will first try to understand if your scoliosis is due to an underlying cause and if that cause can be fixed in scoliosis treatments.
Non-invasive measures such as bracing can be tried, but some cases will require corrective or pain-relieving surgery.
Scoliosis symptoms
Initial symptoms of scoliosis may include:
- Sloping or uneven shoulders.
- A highly visible shoulder blade.
- An uneven waist.
- Even a slight overall tilt to one side.
One leg may appear longer than the other, or one hip will appear higher than the other.
Common symptoms of scoliosis include:
- Changes in gait when walking.
- Reduced range of motion.
- Pain anywhere in the back or neck.
Diagnosis
The most apparent symptom of scoliosis is the curvature seen in the spine.
Scoliosis often first appears during a person’s teenage growth periods.
While scoliosis affects girls and boys relatively similarly, the condition tends to be worse in women compared to men.
Adult-onset scoliosis is generally the result of wear and tear on the body that comes with age.
After the initial examination, if the curvature is not pronounced or even invisible to the naked eye, MRI and CT scans are used to fully assess the severity of the condition and often be able to detect it.
Many cases are small enough not to require extreme treatment measures, and back pain is generally not a symptom of scoliosis.
Treatments and procedures for scoliosis
There is a first treatment option to wear a brace, and it works best when the patient is still growing.
This is the first treatment for cases where the patient’s spine has a 25 to 40% curvature.
The corset can help guide the spine to straighten as it grows rather than continuing to curve.
If the corset is removed before the spine has finished growing, the spine will likely return to its curved position.
Treatment and procedure options for scoliosis range from conservative options like injections to more intensive procedures like spinal fusions.
Conservative treatment options include nerve root blocks and steroid injections.
These are designed to provide temporary relief (up to a year), and you may choose to have the procedure done multiple times.
Other conservative strategies may include the placement of a spinal cord stimulator, which is designed not to correct underlying degeneration but to decrease pain caused by the condition.
Decompression can be used for cases where the structural integrity of the vertebrae or spinal cord is not threatened.
These procedures focus on freeing the trapped nerves, usually increasing the space through which the nerves pass.
Depending on the demands of the procedure and your unique physiology, a special surgical laser may be used.
Fusion procedures, also called stabilization, can be used when the stability of the spine or vertebrae is compromised or threatened.
There may be more than one harmful condition in some of these cases.
While these procedures are minimally invasive and enjoy a high success rate in some patients.
