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Scoliosis: Dealing with Different Curves
The spine is the architectural foundation of the body, providing form as well as function. Viewed from the side, the spine’s curves round out the shoulders and draw in the lower back. These curves are normal. However, when a back viewed from behind shows lateral, or side-to-side curves, it is a sign of the abnormal spinal curvature known as scoliosis. In an X-ray, the spine will look more like an "S" or "C" than a straight line. Who is affected?
Scoliosis affects about 2 percent of the population and is usually first noticed in adolescence. Adults are sometimes diagnosed, but this is typically due to pre-existing scoliosis that was not identified earlier. Girls are more likely than boys to develop curvature that requires treatment. Because the curvature can worsen as the bones mature, many schools have scoliosis screening programs. Parents should be aware of warning signs such as uneven shoulders, an uneven waist, or a shoulder blade or hip that is higher or more prominent than the other. What causes scoliosis?
Although 85 percent of cases have no known cause, studies show that many girls with scoliosis reach puberty early, suggesting a hormonal influence. The cause can also be genetic, since scoliosis tends to run in families. Less common types of scoliosis have known causes. These causes include defects present at birth, neuromuscular diseases such as cerebral palsy and muscular dystrophy, connective tissue disorders such as Marfan’s syndrome and chromosomal abnormalities such as Down’s syndrome. What treatments are available?
There are three methods of treating scoliosis, depending on age, skeletal maturity and the degree and location of the curve: - Observation. Mild curves — less than 20 degrees — require no treatment. However, children should receive annual exams throughout the growing years to ensure that the curves do not worsen. Adults can be examined less frequently.
- Braces. For children with moderate curvature — 25 to 40 degrees — braces can be used to halt the progression of scoliosis. Most modern braces cannot be seen beneath clothing and are worn 16 to 20 hours a day. Those who wear braces may participate in all normal activities.
- Surgery. Surgery is recommended for curves greater than 40 to 50 degrees, and in curves that continue to increase after skeletal maturity. The procedure involves fusing affected vertebrae to solid bone using instruments such as rods and wires. Although strenuous activities are restricted during the first few months following surgery, patients can move about normally. The fusion process can take anywhere from three to 12 months and can improve curvature by as much as 50 percent.
The vast majority of those with scoliosis experience no pain and very slight deformity, especially when the condition is diagnosed early. With proper treatment, virtually anyone with scoliosis can live an active and normal life.
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