Understanding a very difficult disease
Scoliosis is a sideways curvature of the spine that is classified by the three major characteristics: the cause of curvature if known, the size of curve, and the time of diagnosis.
Scoliosis can be caused by conditions such as:
- Cerebral palsy and muscular dystrophy (neuromuscular scoliosis)
- Accidents (traumatic scoliosis)
- A defect in the spine such as hemivertebra (congenital scoliosis)
- A result of spinal degeneration (degenerative scoliosis)
However, majority of scoliosis’ are classified as Idiopathic. Idiopathic means that there is no known singular cause of the patient’s scoliosis. Most experts regarding scoliosis believe scoliosis is a multifactorial condition that has many factors that can contribute to the development of a scoliosis and a whole other set of factors that contribute the progression.
Scoliosis is prevalent in 4.5% of adolescents. The rate of scoliosis increases with age with studies noting that adult rates are around 20%, while elderly rates can be as high as 68%. Scoliosis is a potentially progressive disease with these three distinctive phases:
Mild scoliosis carries a significant risk of progression (up to 22%). Once the scoliosis passes 20°, risk of progression more than triples to 68%.
Research suggests that if the Cobb angle is initially diagnosed at 25 degrees or higher, it will most likely progress.
Without treatment, further progression is almost certain. Severe scoliosis carries a 90% risk of progression.
SCOLIOSIS BY AGE
Scoliosis may be diagnosed at any age. While it is predominantly diagnosed in teens and pre-adolescents, it also commonly occurs in people of any age. While the disease itself appears in all age groups, how it is approached and treated varies greatly from age to age.
Traditional treatment OPTIONS
Observation is generally referred to as “watch and wait.” Even though this is an option, no active treatment is provided. Most studies show that scoliosis can progress during someone’s life, either rapidity during puberty, or slower during adulthood. Watching and waiting for curve to get bigger makes every treatment option more challenging in the future.
The most-commonly prescribed brace for scoliosis today is the Boston brace. A Boston brace is typically made from one of several prefabricated mold options. This prefabrication is the major concern of this type of brace, as effectiveness of the brace will depend on the modifications made, if any, by the fitter. A poorly designed brace can have a negative impact on scoliosis.
Surgery has one primary goal, to halt the progression of scoliosis by using some type of spinal fusion. Successful surgery is considered when the scoliosis progression has been halted, however it has been increasingly recognized by scoliosis experts that this always doesn’t mean a healthy person. Things like physical appearance, pain levels, quality of life may be negatively affected by surgery. If surgery doesn’t achieve the desired outcome, option for further treatment can be limited.