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  Scoliosis  
 
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Contributing risk factors | Recommendations

 

Scoliosis is not just a curved spine. Scoliosis affects the muscles and ligaments of the spinal column. This causes the spine, ribs, and pelvis to twist and rotate front to back and up and down, as well as sideways. This is very different from most people’s understanding of scoliosis as simply a lateral (sideways) curve of the spine. Scoliosis also impairs the bodies neurological, hormonal, and nutritional systems. Physician's are now understanding that symptom's of scoliosis may vary on an individual basis. Many may experience mood swings, headaches, digestive problems, menstrual-cycle disturbances, leg, hip and knee pain. An estimated 80% of all diagnosed cases of scoliosis are considered idiopathic. Idiopathic means “no known cause” – the patient simply had the potential for scoliosis to have appeared at any time in his or her life. Idiopathic scoliosis may appear in either gender, and at any time in life, although it usually appears in early adolescence.

Idiopathic scoliosis often runs in families and appears to be due to genetic or hereditary factors. It is not known what "triggers" the development of the curve, or why some curves progress more than others. Scoliosis may occur in children who are otherwise perfectly healthy.

Scoliosis may be caused by nerve and muscle disorders, such as cerebral palsy, muscular dystrophy and polio. Other known causes of scoliosis include:

CONGENITAL - which is caused by abnormalities in the formation of the vertebrae present at birth
CONNECTIVE TISSUE DISORDERS such as Marfan's Syndrome
CHROMOSOMAL ABNORMALITIES such as Down's Syndrome.

During adolescence scoliosis usually produces no pain and may be difficult to detect. Mild scoliosis may be present for several years before it is seen. One of the easiest ways to detect it is by using the forward bending examination. Most importantly, the physician should check the child's spine regularly until growth is complete since scoliosis may appear at any time during the last major growth spurt.

Scoliosis occurs relatively frequently in the general population, and its frequency depends upon the magnitude of the curve being described. Scoliosis of greater than 25 degrees has been reported in about 1.5/1000 persons in the United States.

Scoliosis is typically diagnosed when changes in posture are detected. However, scoliosis has been at work in the body long before the skeletal system is noticeably affected. Scoliosis does begin a more dramatic progression during hormonal changes such as puberty, pregnancy, or menopause. The key to successful treatment is the early identification of scoliosis before large spinal curves are present.

Most curves can be treated nonoperatively if they are detected before they become too severe. However, 60 % of curvatures in rapidly growing prepubertal children will progress. Therefore, scoliosis screening is done in schools across America and several other countries. This screening is probably not necessary until the fifth grade. Beyond that point, boys and girls should be examined every 6 - 9 months. Generally, curvatures less than 30 degrees will not progress after the child is skeletally mature. Once this has been established, scoliosis screening and monitoring can usually be stopped. With greater curvatures, the curvature may progress at about 1 degree per year in adults. In this population, monitoring should be continued.

There are currently no medications to treat scoliosis, nor can its onset be prevented. When scoliosis is detected, the doctor may refer the patient to an orthopedic spinal specialist for evaluation and treatment. This may consist of periodic examinations, including standing X-rays as needed to determine if the curve is increasing in size. If scoliosis is identified early, large curves may often be prevented by wearing a brace. Severe curves may require surgical treatment.
 

 
 

Risk factors for Scoliosis:
 
 
Symptoms - Skeletal  History of scoliosis

Counter-indicators:
  Absence of scoliosis
 
 

Recommendations for Scoliosis:
 
 
Physical Medicine  Physical Supports
 The brace (orthosis) is a device to hold the spine in a straighter position during the growing years. The brace is prescribed by an orthopaedic specialist and is usually worn nearly full-time until bone growth has stopped.

Surgery/Invasive

  Prolotherapy
 Prolotherapy treatments to strengthen the weakened ligaments can have potentially stabilizing and curative effects in scoliosis. If the scoliosis is progressing quickly, then bracing would be necessary in addition to Prolotherapy.

  Surgery
 Many surgical techniques can be used to correct the curves of scoliosis. The main surgical procedure is correction, stabilization, and fusion of the curve. Orthopedic surgeons can advise you on what procedure is the most likely to help.
 
 


KEY
Strong or generally accepted link
Very strongly or absolutely counter-indicative
Likely to help