SCOLIOSIS..SPINAL CURVATURE

Unless you have somebody who is directly affected, this may be the first time you are hearing about the term ‘scoliosis’.  It is a medical condition in which a person's spine is curved from side to side;  the spine of an individual with scoliosis may look more like an "S" or a "C", rather than a straight line. Scoliosis is typically classified as either congenital, idiopathic(cause unknown), or neuromuscular (having developed as a secondary symptom of another condition, such as spina bifida, cerebral palsy, spinal muscular atrophy, or physical trauma). A lesser known underlying cause of scoliosis could be attributed to a condition called Chiari malformation. Scoliosis affects girls twice as often as it affects boys. About three to five of 1,000 people are affected. Scoliosis usually occurs in those older than 10 years, but the condition can be seen in infants.

 Scoliosis Causes

In most cases (85%), the cause of scoliosis is unknown (what doctors call idiopathic). The other 15% of cases fall into two groups: 

·         Nonstructural (functional): This type of scoliosis is a temporary condition when the spine is otherwise normal. The curvature occurs as the result of another problem. Examples include one leg being shorter than another from muscle spasms or from appendicitis. 

·         Structural: In this type of scoliosis, the spine is not normal. The curvature is caused by another disease process such as a birth defect, muscular dystrophy,metabolic diseases, connective tissue disorders, or Marfan's syndrome.

Scoliosis Symptoms

These symptoms are only those associated with the spine being curved:

·         Your head may be off center. 

·         One hip or shoulder may be higher than the other. 

·         You may walk with a rolling gait. 

·         The opposite sides of the body may not appear level. 

·         You may experience back pain or tire easily during activities that require excessive trunk (chest and belly) movement.

 

 

When to Seek Medical Care

Scoliosis usually occurs around age 10 years. Most school systems have screening programs that look for scoliosis. The most common test is to have the child stand with his or her feet straight ahead and with knees locked and then slowly bend over to touch their toes. If the school notifies you that they are concerned, you should contact your doctor to make a routine appointment within the next one to two months.

If your doctor (or pediatrician) examines your child and is suspicious, the doctor may repeat the exam in four to six months to see if there is any change. Most children do not need to be treated for scoliosis when the curvature is mild.

Scoliosis Treatment

The majority of cases of scoliosis do not require treatment. 

·         If the curve is less than 25°, no treatment is required, and the child can be reexamined every four to six months. 

·         If the curve is more then 25° but less than 30°, a back brace may be used for treatment. 

·         Curves more than 45° will need to be evaluated for the possibility of surgical correction. Surgical correction involves fusing vertebrae together to correct the curvature and may require inserting rods next to the spine to reinforce the surgery. 

·         Treatment options depend more on how likely it is that the curve will worsen than on the angle of the curve itself. A child with a 20° curve and four more years of growth may require treatment while a child with 29° of curvature who has stopped growing may not require treatment.

Outlook

With early screening and detection, most children with scoliosis can be treated to prevent more curvature. They can lead normal lives and have the same life span as other healthy people. The prognosis depends more on why the scoliosis occurred. If it occurs because of another disease, the outcome is related to the other disease rather than to the scoliosis.