Scoliosis: What You Need to Know about Scoliosis

Scoliosis: What You Need to Know

Scoliosis is not a disease, but rather it is a term used to describe any abnormal, sideways curvature of the spine. Viewed from the back, a typical spine is straight. When scoliosis occurs, the spine can curve in one of three ways:

  • The spine curves to the side as a single curve to the left (shaped like the letter C), called levoscoliosis
  • The spine curves to the side as a single curve to the right (shaped like a backwards letter C), called dextroscoliosis
  • The spine has two curves (shaped like the letter S).

Idiopathic Scoliosis

adolescent scoliosis

This article focuses on the most common form of scoliosis, idiopathic scoliosis, which occurs in approximately 2% the population. The term idiopathic means a condition or disease with no known cause.

Idiopathic scoliosis is by far the most common cause of scoliosis in children. (Degenerative scoliosis is the most common form of scoliosis in adults.)

Idiopathic scoliosis rarely causes pain, and in most cases the curve is minor enough to be considered an asymmetry and does not require any treatment. However, once scoliosis is detected it should be closely monitored by a medical professional in the event that the curve progresses and needs treatment.

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Because the skeletons of children and young adults grow quickly, there is a reasonable chance that if a curve is detected, the degree of the spinal curve may worsen as the spine continues to grow. In those cases, scoliosis treatment may become advisable. Rarely (in 0.2 to 0.5% of all cases), untreated scoliosis can progress to where it restricts space in the ribcage needed for optimal heart and lung function.1,2

It is important to note that idiopathic scoliosis is not caused by activity such as exercise, sports, or carrying heavy object; nor does it come from sleeping position, posture, or minor differences in leg length.

Detection, Diagnosis, and Monitoring

Scoliosis most typically occurs in individuals 10 to 18 years old and is often detected by school screenings or regular physician visits. A medical professional will look for:

  • Curvature of the spine
  • Uneven shoulders, or protrusion of one shoulder blade
  • Asymmetry of the waistline
  • One hip higher than the other.

Once scoliosis is detected, a physician will continue to monitor the curvature (read more about scoliosis observation). The progression of spinal curvature is very well understood and is measured in degrees.

  • Mild curvature that remains at 20 degrees or less will most likely require monitoring and observation, but further treatment is rarely needed.
  • Curvature greater than 20 degrees may require non-surgical or surgical intervention, including treatments such as a back brace for scoliosis or scoliosis surgery, both of which prevent further progression of the curve.

Preventing severe curvature is important for the physical appearance and health of the patient. Curves greater than 50 degrees are more likely to progress in adulthood. If a curve is allowed to progress to 70 to 90 degrees, it will produce a disfiguring deformity.

A high degree of curvature may also put the patient at risk for cardiopulmonary compromise as the curve in the spine rotates the chest and closes down the space available for the lungs and heart.

Scoliosis Rarely Causes Back Pain

It is important to note that idiopathic scoliosis results in spinal deformity, but is not typically a cause of back pain. Of course, people with scoliosis can develop back pain, just as most of the adult population can develop back pain. However, it has never been found that people with idiopathic scoliosis are any more likely to develop back pain than the rest of the population.

Other Types of Scoliosis

While adolescent scoliosis is the most common, other common types of scoliosis include:

  • Congenital scoliosis, which is present in infants
  • Neuromuscular scoliosis, which is the results of neuromuscular conditions
  • Degenerative scoliosis, which occurs later in life

References:

  1. O'Brien MF, Newman, PO, "Nonsurgical Treatment of Idiopathic Scoliosis," Surgery of the Pediatric Spine, ed. Daniel H. Kim et al. (Thieme Medical Publishers, 2008), 580. books.google.com.
  2. Good CR, "The Genetic Basis of Idiopathic Scoliosis," Journal of the Spinal Research Foundation, 2009:4:1:13-5, www.spinemd.com.
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Article written by: Peter F. Ullrich, Jr., MD