Scoliosis

What is Scoliosis?

Scoliosis is the side to side curvature of the spine. Every spine has a natural front to back curve. A side to side curve may look like an “S” (double curve) or a “C” (single curve). Scoliosis is more than just a curve to the side - it can also involve twisting/rotation of the spine. A curve that is greater than 10 degrees is considered scoliosis.

What are the types of Scoliosis?

  • Idiopathic — no known cause. This is the most common.
  • Early Onset (0-10 years)
    •  Infantile (ages 3 years and under)
    • Juvenile (ages 3-9 years)
  • Adolescent (ages 10-18 years)
  • Adult (after skeletal maturity)
  • Syndromic — related a diagnosed syndrome.
  • Neuromuscular — related to a neurological condition such cerebral palsy, spina bifida, etc.
  • Congenital — related to a misshaped or malformed vertebra or spinal structure.

What is the cause of Scoliosis?
80% of the cases do not have a cause or they are “idiopathic”. Other causes can include:

  • Arthrogryposis
  • Congenital Deformities
  • Genetic Syndromes
  • Neuromuscular problems
  • Limb length inequality
  • Cerebral Palsy
  • Spina Bifida
  • Muscular Dystrophy
  • Spinal Muscular Atrophy
  • Tumors

What are the warning signs of Scoliosis?

  • Shoulder height difference
  • Head is not centered over body
  • Hip imbalance
  • Rib cage asymmetry
  • Changes in look or textures of the skin overlying the spine (hairy patches, color changes)
  • Leaning of entire body on one side

How is it diagnosed?
A diagnosis of scoliosis is made by physical exam, x-rays, and patient history. In some cases, more tests such as MRI and CT are ordered to help guide treatment.

What questions will the Orthopedic Surgeon ask?

  • Age?
  • Who noted the problem?
  • Patient’s perinatal history?
  • Meet on normal milestones?
  • Family history of scoliosis? Back problems?
  • Pain?
  • Numbness/ tingling in legs?
  • Bowel or bladder problems?

What is the treatment for Scoliosis?

  1. Observation:
    • Curves under 20 degrees require observation
    •  X-rays once every 6 months until the patient is done growing
  2. Bracing: This type of treatment is decided by the surgeon. Braces are a custom fit to your body, and a thin shirt can be worn underneath the brace to prevent skin breakdown. The brace can also be hidden under clothes. 
    •  Curves 25-45 degrees
    •  Prevention of spine curvature worsening
    •  Visits every 6 months to check spine
    •  Brace wear is 20 to 24 hours a day until end of growth
  3.  Surgery:

What are the effects of scoliosis?

  • Back Pain
  • Cosmetic appearance
  • Decrease lung capacity and exercise tolerance

What factors determine treatment?

  • Age
  • Bone age
  • Degree of curvature of spine
  • Location of curvature
  • When menses was started
  • Gender
  • Increase of curve
  • Back pain
  • Shortness of breath

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