Scoliosis is an abnormal curvature of the spine (backbone). There is a natural, forward-and-backward curve to the spine. With scoliosis, the spine rotates and develops a side-to-side curve.
Most cases of scoliosis are mild and don’t need treatment. In adults, the degree of the spinal curve may or may not determine treatment. Treatment is geared towards relieving symptoms, and not necessarily fixing the curve. The goal is always to decrease pain and improve function.
Types of Scoliosis
Idiopathic scoliosis is scoliosis without a known cause. In as many as 80% of cases, doctors don’t find the exact reason for a curved spine.
Congenital scoliosis begins as a baby’s back develops before birth. Problems with the tiny bones in the back, called vertebrae, can cause the spine to curve. The vertebrae may be incomplete or fail to divide properly. Doctors may spot this rare condition when the child is born. Or they may not find it until the teen years.
Neuromuscular scoliosis is caused by a disorder like spina bifida, cerebral palsy, or a spinal cord injury. These conditions sometimes damage your muscles so they don’t support your spine correctly. That can cause your back to curve.
Degenerative scoliosis affects adults. It usually develops in the lower back as the disks and joints of the spine begin to wear out as you age.
Causes and Risk Factors
Some kinds of scoliosis have clear causes. Doctors divide those curves into two categories — structural and nonstructural.
In nonstructural scoliosis, the spine works normally but looks curved. This happens for a number of reasons, such as having one leg that’s longer than the other, muscle spasms, and inflammations like appendicitis. When these problems are treated, the scoliosis often goes away.
In structural scoliosis, the curve of the spine is rigid and can’t be reversed.
- Cerebral palsy
- Muscular dystrophy
- Birth defects
- Genetic conditions like Marfan syndrome and Down syndrome
For idiopathic scoliosis, family history and genetics can be risk factors. If you or one of your children has this condition, make sure your other kids are checked regularly.
Signs of Scoliosis
Oftentimes scoliosis is first suspected when someone notices something slightly off and comments. Some examples could include:
- Clothes fit awkwardly or hang unevenly. Person with scoliosis might notice that a shirt or blouse appears uneven, which could be cause for further investigation.
- Sideways curvature observed while in bathing suit or changing. For instance, a parent could first notice the sideways curvature in an adolescent’s back while at the pool or beach.
Some of the more common symptoms present in moderate or severe scoliosis could include:
- Changes with walking. When the spine abnormally twists and bends sideways enough, it can cause the hips to be out of alignment, which changes a person’s gait or how they walk. The extra compensating that a person does to maintain balance for the uneven hips and legs can cause the muscles to tire sooner. A person might also notice that one hand brushes against a hip while walking but the other does not.
- Reduced range of motion. The deformity from spinal twisting can increase rigidity, which reduces the spine’s flexibility for bending.
- Trouble breathing. If the spine rotates enough, the rib cage can twist and tighten the space available for the lungs. Bone might push against the lungs and make breathing more difficult.
- Cardiovascular problems. Similarly, if the rib cage twists enough, reduced spacing for the heart can hamper its ability to pump blood.
- Pain. If curvature becomes severe enough, back muscles could become more prone to painful spasms. Local inflammation may develop around the strained muscles, which can also lead to pain. It is possible for the intervertebral discs and facet joints to start to degenerate due to higher loads.
- Lower self-esteem. This symptom is commonly overlooked or minimized by outside observers, but it can be a significant factor for people who have a noticeable spinal deformity. Especially for adolescents who want to fit in with their friends, it can be stressful and depressing to look different, have clothes fit unevenly, or wear a noticeable back brace that may be uncomfortable or limit activity.
For mild scoliosis, you may not need treatment. Instead, your doctor at Westminster clinic, Dubai might watch you and take X-rays once in a while to see if it’s getting worse. Some children grow out of scoliosis.
If you or your child need treatment, your doctor might suggest:
- Braces. In kids who are still growing, wearing a brace around your torso can stop the curve from getting worse. They’re usually made of plastic. Many kids wear them 24 hours a day. You can’t see them under clothes, and they don’t stop you from doing everyday activities.
Choosing Observation vs. Bracing
About 90% of idiopathic scoliosis cases are mild and only require observation. Typically, observation is done by a doctor every 4 to 6 months until the adolescent has reached full skeletal maturity.
There are two general treatment options for scoliosis bracing:
- Full-time bracing. These braces are designed to be worn 16 to 23 hours a day. The goal is to wear them all the time with exceptions for bathing, skin care, and exercising.
- Nighttime bracing. These braces use hyper-corrective forces (which put the body out of normal balance and cannot realistically be applied while a person is standing and/or performing daily activities) and are to be worn at least 8 hours a night.
- Spinal fusion surgery. In this operation, your doctor puts pieces of bone or a similar material between bones in your spine. They use hardware to hold the bones in place until they grow together, or fuse. The surgery can lessen the curve in your spine as well as keep it from getting worse.
- Spine and rib-based growing operation. This is done to correct more serious scoliosis in children who are still growing. The doctor attaches rods to your spine or ribs with hardware. As you grow, the doctor adjusts the length of the rods.
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- orthoinfo.aaos.org – American Academy of Orthopedic Surgeons
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