Scoliosis is a condition wherein the spine is curved laterally, or to the side. Five to seven million Americans have scoliosis and there are more than half a million visits to doctors for examination and treatment of scoliosis every year.
Symptoms of Scoliosis
The normal spine, when viewed from the front, is straight. A spine with scoliosis, on the other hand, shows a slight outward curvature in the upper back and bends inward at the lower back portion.
Although scoliosis can affect people at any age, it develops most often in young people between 10 and 16 years of age. Many of these cases involve minor curvatures that are less than 20 degrees. Less than 0.1 percent involve spinal curves greater than 40 degrees. It is the lower threshold when surgery as a treatment option is to be considered. It cannot be explained why in most cases, scoliosis appears in adolescents who had normal spines previously. There are more girls than boys affected by scoliosis. Girls also tend to develop worse curve conditions.
Types of Scoliosis and Their Causes
There are many types of scoliosis:
Congenital scoliosis – This is caused by abnormality in the bone, which is present at birth.
Neuromuscular scoliosis – This type of scoliosis results from abnormality in the nerves or muscles and are seen in people with cerebral palsy, spina bifida or other conditions that are accompanied by or result in paralysis.
Degenerative scoliosis – This is the type of scoliosis resulting from bone collapse from previous illness or injury, major back injury or osteoporosis.
Idiopathic scoliosis – This is the most common type of scoliosis. There is no known identifiable cause for idiopathic scoliosis. Although many theories are being espoused, not one is found conclusive. Strong evidences though point to idiopathic scoliosis as being inherited. Idiopathic scoliosis may progress during the adolescent years but spinal curving usually stops in adulthood.
Treatment Options for Scoliosis
About 90 percent of all scoliosis conditions involve unnoticeable to mild spine curvature – less than 20 degrees. As long as there are no further deterioration observed in the condition, they are not a cause for alarm, nor do they require active treatment.
The treatment options for scoliosis depend on the patients’ age, gender, location and severity of the spine condition and associated symptoms such as back pain. A few of these treatment options are:
Bracing – This is usually recommended for adolescents who have spinal curve between a 25 and 40 degrees to prevent further progression of their spinal condition. Bracing is usually prescribed when the person has at least two more growth years remaining. Although bracing may stop progression of the spinal curving when it is used, the original magnitude of the spinal curve returns with the removal of the brace. The brace is designed to be well-fitted and is replaced if the child or adolescent outgrows it.
Surgery – Most scoliosis surgeons agree that severe spine conditions where the curvature is greater than 45 degrees will need surgery to lessen the curve and prevent its deterioration. Surgery though does not perfectly straighten the spine. During the surgical procedure, metal implants are first used to correct some of the curvature and hold the spine in the correct position. Bone graft, placed at the time of the surgery, creates a fusion and consolidates the vertebrae in the area of the curve.
In small children, an alternative option is surgery that does not involve fusion as it stops the growth of the fused portion of the spine. Brace is usually used after this particular surgical procedure.
Other treatment options – Chiropractic spinal manipulation, electrical muscle stimulation and physical therapy are the other options recommended in the treatment of scoliosis although it has been noted that scoliosis reduction could not be achieved by any one of these therapies on their own. Chiropractic care tends to be the most effective method in the treatment of acute, short term pain that accompanies scoliosis.
Scoliosis cannot be totally prevented. Regular examination of the spine condition especially in children is very helpful in diagnosing it and applying the type of treatment required to prevent it from worsening and to properly manage it.