ADOLESCENT MEDICINE :: Orthopaedic Problems
What is scoliosis?
A normal spine, when viewed from behind, appears straight. However, a spine affected by scoliosis shows evidence of a lateral, or sideways, curvature, and a rotation of the back bones (vertebrae), giving the appearance that the person is leaning to one side. The Scoliosis Research Society defines scoliosis as a curvature of the spine measuring 10 degrees or greater on x-ray.
Scoliosis is a type of spinal deformity and should not be confused with poor posture.
Four common types of curve patterns seen in scoliosis are:
What causes scoliosis?
In most (80 to 85 percent) cases, the cause of scoliosis is unknown - a condition called idiopathic scoliosis. Scoliosis is more common in females than males.
According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, three to five out of every 1,000 children develop spinal curves that are considered large enough to require treatment.
The American Academy of Orthopaedic Surgeons, in cooperation with the Scoliosis Research Society, describe three different types of scoliosis that can occur in children - congenital (present at birth), neuromuscular, or idiopathic.
Other causes of scoliosis may include:
What are the symptoms of scoliosis?
The following are the most common symptoms of scoliosis. However, each adolescent may experience symptoms differently. Symptoms may include:
Back pain, leg pain, and changes in bowel and bladder habits are not commonly associated with idiopathic scoliosis. A adolescent experiencing these types of symptoms requires further medical evaluation by a physician.
The symptoms of scoliosis may resemble other spinal conditions or deformities, or may be a result of an injury or infection. Always consult your adolescent's physician for a diagnosis.
How is scoliosis diagnosed?
The physician makes the diagnosis of scoliosis with a complete medical history of the adolescent, physical examination, and diagnostic tests. The physician obtains a complete prenatal and birth history of the adolescent and asks if other family members are known to have scoliosis. The physician will also ask about developmental milestones since some types of scoliosis can be associated with other neuromuscular disorders. Developmental delays may require further medical evaluation.
In addition to a complete medical history and physical examination, x-rays (a diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film) are the primary diagnostic tool for scoliosis. In establishing a diagnosis of scoliosis, the physician measures the degree of spinal curvature on the x-ray.
The following other diagnostic procedures may be performed for nonidiopathic curvatures, atypical curve patterns, or congenital scoliosis:
Early detection of scoliosis is most important for successful treatment. Pediatricians or family physicians, and even some school programs, routinely look for signs that scoliosis may be present.
Treatment of scoliosis:
Specific treatment of scoliosis will be determined by your adolescent's physician based on:
The goal of treatment is to stop the progression of the curve and prevent deformity. Treatment may include:
According to the Scoliosis Research Society, there is no scientific evidence to show that other methods for treating scoliosis (i.e., manipulation, electrical stimulation, and corrective exercise) prevent the progression of the disease.
Long-term outlook for an adolescent with scoliosis:
The management of scoliosis is individualized for each adolescent depending on his/her age, amount of curvature, and amount of time remaining for skeletal growth. Scoliosis will require frequent examinations by your adolescent's physician to monitor the curve as your adolescent grows and develops. Early detection is important. If left untreated, scoliosis can cause problems with heart and lung function.
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It is important to remember the health information found on this website is for reference only not intended to replace the advice and guidance of your healthcare provider. Always seek the advice of your physician with any questions you may have regarding a medical condition. If you think you may have a medical emergency, call your physician or 911 immediately.
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