Scoliosis, the s-curvature of the spine, is an abnormality that shows no deference to age, afflicting newborns to adults. Like other diseases, it varies in severity from mild to severe. In order to obtain the best outcome, individuals need to catch the condition early and follow the right course of treatment.
Scoliosis is generally defined by the American Association of Neurological Surgeons (AANS) as “an abnormal lateral curvature of the spine.” This abnormal curvature manifests itself in four types of diagnosable scoliosis.
- Congenital scoliosis occurs when the vertebrae of the embryo fail to form properly. According to Stanford Children’s Health, the malformation can present itself as missing vertebrae, vertebrae that do not fully separate, or partially formed vertebrae. This type of scoliosis is generally detected at a young age and can be carefully monitored and treated.
- Neuromuscular scoliosis is closely associated with other neurological or muscular diseases like cerebral palsy or muscular dystrophy. A spinal injury that prevents a child from walking may also be associated with this form. Neuromuscular scoliosis often progresses rapidly and requires surgery to correct it.
- Adolescent idiopathic scoliosis is diagnosed “when all other causes are excluded” (AANS). This type of scoliosis comprises about 80 percent of all cases and appears during the adolescent years. The Scoliosis Research Society states that the cause of idiopathic scoliosis is unknown, but researchers suspect that there may be a link between hormones and this condition. Genetics are another possible contributing factor since 30 percent of those who develop adolescent idiopathic scoliosis have a family history of scoliosis.
- Adult idiopathic scoliosis often presents itself during adolescence but worsens during adulthood, or it has an onset during adulthood due to some other factor.
Because scoliosis affects the shape of the spine, detecting the problem is fairly simple. Some of the most common symptoms affect the way an individual appears when standing.
- The shoulders will rest unevenly with one sitting higher than the other.
- One or maybe both shoulder blades will protrude.
- When standing straight, the head will not be centered directly over the pelvis.
- One or both of the hips will appear to sit higher than normal.
- Due to the curving of the spine, the waist will not sit evenly, and the rib cages will be at different heights.
- The person’s body will lean to one side to accommodate the irregular shape of the spine.
- Even the skin overlaying the spine may be different in texture from the surrounding skin, containing dimples, color abnormalities (café-au-lait spots), or hairy patches.
- When the individual bends at the waist, the sides of the back will appear to be different heights.
In order to obtain a diagnosis of scoliosis, doctors will take a detailed medical history of the patient and do a physical exam. AANS states that the Adam’s Forward Bend is a typical screening method doctors use for an initial analysis. The patient does a 90-degree bend at the waist, and the doctor looks for any asymmetry in the individual’s trunk. Other tests a doctor might order are an x-ray, magnetic resonance imaging (MRI), and computed tomography scan (CT). He uses these to determine how severe the scoliosis is and which of the three treatment options is appropriate for the patient.
- Observation – According to the Scoliosis Research Society, if the curve is less than 25 degrees and the individual is still growing, doctors will observe the patient, having the individual return every four to six months. If the curve is less than 50 degrees and the patient has stopped growing, the doctor will also use observation, having the individual return for an x-ray every five years.
- Bracing – A moderate curve of 25 to 40 degrees in an individual who is still growing is generally treated with a brace that is worn 16 to 23 hours a day. The goal is to prevent further curving of the spine and keep the curve to 45 degrees or less.
- Surgery – For individuals who have severe curvature, more than 45 degrees, and are still growing and bracing has not slowed the progression of the curvature, surgery is the solution. Those who have stopped growing and have a curve of 50 degrees or more also require surgery to correct the problem. The goal of the surgery is to prevent any curving in the future and to correct the curve to some extent.
Although scoliosis is not preventable or curable, it is treatable. Catching the problem early means a better chance at limiting the amount of curving the spine does and getting it to stabilize into the least possible curve. If you are concerned that you or someone you love may have scoliosis, schedule an appointment with the specialists at Atlanta Brain and Spine Care. Our caring staff can get you an accurate diagnosis and appropriate treatment plan, helping take the “curves” out of life.