Scoliosis is a disorder in which the spine curves abnormally from side to side. It can affect any part of the spine but the most common regions are the chest area (thoracic scoliosis) or the lower part of the back (lumbar scoliosis). Scoliosis can affect people of all ages but most commonly affects children from 10-12 or in their early teens. The majority of younger children with scoliosis usually require no treatment, as the condition resolves on its own as the child grows. However adults can also be affected by scoliosis as well.
In most cases (85%), the cause of scoliosis is unknown (or idiopathic). The other 15% usually fall into two groups:
- Nonstructural (functional): This type of scoliosis is a temporary condition when the spine is otherwise normal. The curvature occurs as the result of another problem such or as having one leg shorter than the other.
- Structural: In this type of scoliosis, the spine is not normal. The curvature is caused by another disease process such as a birth defect, muscular dystrophy, metabolic diseases, connective tissue disorders, or Marfan's syndrome.
The symptoms of scoliosis vary from case to case however normal symptoms can include:
- Shoulders may not be the same height
- Head may not be centered above the pelvis
- Ribcage is not symmetrical; ribs may be at different heights
- One shoulder blade may be higher and more prominent than the other
- One hip may be more prominent than the other
- May walk with a rolling gait
- Clothes do not hang properly
- Person may lean to one side
- Legs may be of uneven lengths.
- A bulge may be present on one side of the chest
- The baby may be consistently lying curved to one side
Diagnosis for scoliosis begins with a complete review of your medical history to determine if the scoliosis may be hereditary, when you first noticed it, and symptoms, etc. If a child is of school age and their pediatrician is suspicious, they may repeat the exam in four to six months to look for any change. Most children do no need to be treated for scoliosis when the curvature is mild.
A physical exam will also be done to evaluate the spine visually and the doctor may have the patient stand straight forward with the feet straight ahead and the palms inward. With the knees locked, the patient slowly bends over at the waist and tries to touch their toes. The doctor can get a visual appearance of the spine through the skin.
X-rays may be necessary in order to measure the curvature. Depending on the degree of the curve and whether it worsens over time, the doctor may recommend further treatment. Our experts at SCCNS see patients from 12 on up and can help these patients with different treatment options.
Luckily the majority of Scoliosis cases do not require treatment. There are several determining factors in treatment options and our experts at SCCNS will evaluate each patient on an individual case by case basis. Things that are taken into consideration when determining a treatment plan include:
- If in a child the curve is less than 25°, no treatment is required, and the child can be reexamined every four to six months.
- If in a child the curve is more than 25° but less than 30°, a back brace may be used for treatment.
- Curves more than 45° will need to be evaluated for the possibility of surgical correction. Surgical correction involves fusing vertebrae together to correct the curvature and may require inserting rods next to the spine.
If a surgical procedure is found to be necessary, it should only be done by an expert in the field. Our surgeons are all experts in spine surgery and are all board certified. They have put in extensive hours on this type of procedure and have had above satisfactory results. You doctor will discuss the type of procedure with you so that you understand your condition and the treatment options and are able to make an informed, educated decision in regard to your treatment plan.