Scoliosis is a disease of the spine which affects about 2% – 3% of the pediatric population and up to 30% of adults worldwide. The basic meaning of scoliosis is an abnormal curvature of the spine (levoscoliosis – is a curve to the left, dextroscoliosis – is a curve to the right). The general appearance of the spine of a person with scoliosis is in the shape of an “S” or “C”, but with x-ray or MRI you will certainly see a more complex three-dimensional deformity similar to a spiral staircase. A diagnosis of scoliosis can be described as Cobb angle (curvature) exceeding 10 degrees with a rotation of the vertebrae. Cobb angle exceeding 25 degrees are considered significant and an angle exceeding 40 degrees is viewed as severe.
There are two main classifications: Firstly there is idiopathic which means the cause is not clear and contains about 80% of cases. In the remaining 20% of cases there are more obvious causes such as: spinal cord injuries causing paralysis, bone deformity, legs are of different length, congenital, neuromuscular disorders, degenerative diseases etc. Scoliosis causes remain a mystery to the medical community, and there are many theories that have not yet been tested. One theory being tested is a genetic connection, which is why it’s recommended if family member is diagnosed with a scoliosis, then the whole family be tested. Still at the testing stage, a genetic test has been developed by scientists at Sainte-Justine Hospital in Montreal and it looks very promising for genetic screening of individuals at risk.
Scoliosis can reduce quality of life by restricting activities, cause scoliosis pain and suffering and damage to the lung and heart function. There are various scoliosis symptoms and signs:
- Shoulder heights are uneven
- One prominent shoulder blade
- Rib cage height not equal
- The appearance of prominent hip
- Unequal Pelvis
- Body leans to one side or the other
- Uneven distance between the arm and pelvis
Scoliosis pain may not develop until it is well established and includes: back pain, pain around the ribs, fatigue and breathing problems along with other symptoms.
A normal spine is a relatively straight line from the bottom of neck to the buttocks. If you suspect a child may have scoliosis, the view from the back shows one or more curves that are not natural. A test often used by doctors is a bending test (Adam’s forward bending test). To perform the test, the patient is asked to lean forward, have feet together, and bend to 90 degrees at hips. The examiner can easily see from this vantage point any trunk asymmetry or abnormal curvature of the spinal column. If the test is positive; a confirmation by X-ray or MRI is needed and is used to determine the severity of the disease and treatment options for the patient.
Children and Scoliosis
Child scoliosis has three categories determined by age factors: infantile scoliosis, juvenile scoliosis and adolescent scoliosis. Infantile contains only 1% of all cases of idiopathic scoliosis. Juvenile is characterized as the first diagnosis between the ages of 4 to 9 and comprises approximately 10% to 15% of all child idiopathic scoliosis. Adolescent scoliosis is ages 10-18 and is currently the most common orthopedic disease in children comprising of approximately 80% of cases. This type of spinal curvature takes place around puberty and is the most severe form that leads to advancing curvature and rotation of the spinal vertebrae. It is crucial to intervene in child scoliosis if he or she is aged 12 and under, and curvature of more than 20° or first-degree family history.
The classification of adult scoliosis is determined is if the patient is over 18 years of age and has passed puberty. This may occur as a continuation of the disease from a child to an adult or adult degenerative scoliosis (De Novo), and usually associated with pain and neurological disorders resulting from compression of the spinal column and nerve roots. Adult scoliosis tends progress at a rate of 1 to 4° per year in adults with a Cobb angle of 30° and over. There are many causes of adult scoliosis: osteoporosis, neuromuscular disorders such as muscular dystrophy, spinal degeneration, injuries causing damage of the spinal column.
Is there a Scoliosis Cure?
No complete cure has been found, but there has been major advancements and break through in the way the disease is treated and managed through non-surgery and surgical procedures. Some treatment options include: SpineCor brace (soft brace), chiropractic care, physical therapy, exercise and more. Even with no cure many scoliosis patients live a relatively pain free and normal life with proper treatment of their disease.