Scoliosis

Most cases of scoliosis are idiopathic, meaning there is no known cause. It often appears during adolescence, particularly in girls. However, congenital, neuromuscular, and syndromic forms have specific causes like abnormal vertebral formation or underlying neurological conditions.

Diagnosis begins with a physical examination, including the forward bending test. If scoliosis is suspected, X-rays are used to measure the degree of the spinal curvature. Additional tests, like MRIs, may be performed in more complex cases to rule out neurological causes.

Idiopathic scoliosis cannot be prevented since its cause is unknown. Congenital scoliosis, which occurs due to spine malformations at birth, is also not preventable. Preventive strategies are not applicable for the majority of scoliosis types.

If untreated, curves greater than 50 degrees often continue to worsen, potentially leading to severe spinal deformities, chronic pain, and in rare cases, cardiopulmonary complications if the curve impinges on the lungs and heart.

Structural scoliosis involves a permanent curve with vertebral rotation, often requiring treatment. Non-structural scoliosis, or functional scoliosis, is a temporary curve without vertebral rotation and is often caused by factors like muscle spasms or differences in leg length.

Idiopathic scoliosis typically develops during adolescence, between the ages of 10 and 15, coinciding with growth spurts. However, congenital scoliosis is present at birth, and neuromuscular scoliosis can develop at any age depending on the underlying condition.

Curves less than 30 degrees typically do not progress into adulthood after skeletal maturity. However, curves greater than 50 degrees tend to progress by about 1 degree per year, even after growth has stopped.

Most individuals with mild to moderate scoliosis can engage in normal physical activity without restrictions. For severe cases, activities involving excessive twisting of the spine may need to be limited. Post-surgery, patients are often advised to avoid high-impact activities for a period to allow the spine to heal.

While back pain is not a common presenting symptom of idiopathic scoliosis, about 25% of adolescents with scoliosis report some back pain. Severe cases, or scoliosis related to other conditions, may cause significant pain due to muscle imbalances or nerve compression.

Yes, there is a genetic component to scoliosis. Children and siblings of patients with idiopathic scoliosis have a higher likelihood of developing the condition. However, scoliosis does not follow a simple pattern of inheritance, and other factors likely play a role.

Surgery is generally recommended for curves greater than 45-50 degrees in growing patients or for curves that continue to progress after skeletal maturity. It is also considered when the patient experiences significant discomfort or deformity that affects daily activities.

Bracing does not correct scoliosis but is intended to prevent the curve from worsening during growth. It is most effective for curves between 25 and 40 degrees in growing children. Compliance with wearing the brace is crucial for its success.

The most common surgery for scoliosis is spinal fusion, which involves correcting the curve using rods, hooks, screws, and wires, then fusing the vertebrae with bone grafts. This procedure stabilizes the spine and prevents further progression of the curve.

As with any major surgery, there are risks, including infection, bleeding, nerve damage, or complications related to the anesthesia. However, advancements in surgical techniques have significantly improved safety and outcomes.

Yes, adults with scoliosis can be treated, although treatment options differ from those for children. Pain management, physical therapy, and in some cases, surgery may be considered. Surgical correction in adults can improve symptoms but may not achieve the same level of curve correction as in children.

Severe scoliosis (usually curves greater than 90 degrees) can impact the chest cavity, restricting lung function and, in rare cases, putting pressure on the heart. This is more likely to occur if scoliosis is left untreated and allowed to progress.

If scoliosis is detected after skeletal maturity, treatment options like bracing are no longer effective. Observation and periodic monitoring are used for smaller curves, while surgery may be considered for larger curves or if symptoms such as pain develop.

Screening programs for scoliosis, such as school-based screenings, are debated. Some organizations recommend routine screening for children between 10 and 14 years, while others argue that the benefits of routine screening are unclear, as it may lead to overdiagnosis.

For most individuals, scoliosis does not limit career choices or everyday activities. However, those with severe scoliosis, or who have undergone spinal surgery, may need to avoid careers that involve heavy lifting or physical strain on the back.

Parents can help by ensuring their child attends regular medical check-ups, adheres to bracing schedules, and maintains a healthy lifestyle that includes physical activity. Providing emotional support is equally important, especially if the child is struggling with body image concerns.

Once the spine has been fused during surgery, the area is stabilized, and the curve should not progress further. However, in rare cases, complications can occur that may require additional surgery, such as rod breakage or failure of the fusion to take hold.

Severe scoliosis can contribute to the early development of degenerative changes or arthritis in the spine due to abnormal wear and tear on the joints. This is more common in adults with untreated scoliosis.

Physical therapy is generally used as an adjunct to other treatments for scoliosis, particularly for pain relief and improving flexibility. However, it is not a cure for scoliosis. Therapy can help improve posture and strengthen the muscles supporting the spine.

Mild to moderate scoliosis is often painless and may not cause symptoms. However, more severe cases can cause discomfort, particularly in the lower back, and may lead to muscle fatigue. Postural imbalances due to scoliosis can also lead to pain over time.

Staying physically active, maintaining good posture, and managing body weight can help alleviate symptoms of scoliosis. In some cases, modifications to workspaces and daily habits may reduce strain on the back.