What is Scoliosis?

Scoliosis is the term used to describe a sideways curve of the spine visible from the back. Most cases of scoliosis are mild and have an unknown cause however the rate of scoliosis is higher in girls. Since scoliosis is most diagnosed in children, an early diagnosis is important to correcting any abnormalities as the child grows.

Most cases of scoliosis generally fall into one of three categories:

  1. A curve to the left forming a “C” shape in the spine called levoscoliosis.
  2. A curve to the right forming backwards “C” shape called dextroscoliosis.
  3. Two curves creating an “S” shape of the spine.

What are the Symptoms of Scoliosis

When viewed from the back a healthy spine will form a straight vertical line while a person with scoliosis will have some lateral curvature in the spine.

An x-ray is the most efficient way of imaging the spine but several other symptoms may point to scoliosis. The Adam’s Forward Bend Test will be conducted as the doctor looks for:

  • A shoulder or shoulder blade sticking out farther or higher than the other
  • One hip or rib cage appearing higher than the other
  • Uneven waist
  • Body tiling to one side
  • One leg appearing shorter than the other

Pain is not a symptom of scoliosis and may be a sign of another medical problem and should be addressed by a healthcare professional.

What Causes Scoliosis?

There is no explicitly determined cause of Scoliosis and a majority of cases do not have a known cause however scoliosis is seen more commonly in girls and is generally diagnosed in adolescents.

Should I See a Doctor for Scoliosis?

Parents who suspect their child may have scoliosis should have their child examined by a healthcare professional. The condition may worsen as a child grows and should therefore be monitored closely in case the curvature expands beyond 20 degrees and requires treatment.

Diagnosing Scoliosis

Diagnosis of scoliosis is most often done by performing the Adam’s Forward Bend Test and checking for the following symptoms:

  • A shoulder or shoulder blade sticking out farther or higher than the other
  • One hip or rib cage appearing higher than the other
  • Uneven waist
  • Body tiling to one side
  • One leg appearing shorter than the other

However an x-ray can also show the same alignment issues in an image form.

Treatment From a Healthcare Professional

A majority of children have a mild form of scoliosis and will not need treatment or suffer any further complications as a result of the condition. Checkups to ensure the curvature does not increase is the standard of care for these mild cases.

The decision to move forward with more aggressive treatment in more moderate to severe cases takes into account:

  • Sex: Girls are far more likely to see symptoms progress
  • Severity of curve: Larger curves are more likely to increase
  • Curve shape: Double curves or “S” curves are more likely to progress than “C” curves
  • Location: Curves in the middle of the back (thoracic) or more likely to progress than the upper or lower spine.
  • Maturity: Bones that have stopped growing are unlikely to see a progression in scoliosis however braces are more effective for a growing back.

Braces

Wearing a brace will not cure scoliosis or reverse a current curve but can prevent a progression of the curve in children who are still growing. A child generally will wear a brace until his or her bones have stopped growing. Therefore a younger child with a large curve is much more likely to need a brace than an older child who has almost reached skeletal maturity.

There are two main types of braces used to treat scoliosis:

  1. thoracolumbosacral orthosis- a more low profile under arm brace designed to conform to the body. As it fits under the arm, these braces are not used for curvatures of the upper back or neck.
  2. bending back brace- less cumbersome, these braces are generally only worn at night during sleep or in cases where a under arm brace will not help. These braces are full torso and can apply pressure against the curve.

Surgery

Surgical options are only considered in extreme cases where the curvature shows no sign of ceasing to progress and is usually done after the child has stopped growing. In these cases the most common surgery is a spinal fusion. In a spinal fusion the surgeon will connect two or more vertebrae so that they no longer move independently.

Spinal Infection

As with all surgical procedures there is an inherent risk of infection involved that only increases with each surgical entry to an area. In the case of scoliosis a spinal infection or infection of the vertebrae, discs, dural sac or area around the spine may occur. The symptoms of a spinal infection include pain, fever,headache, wound redness and tenderness. The doctor will likely then take blood cultures or cultures from the infected area or use imaging techniques such as an MRI or CT scan to diagnose the infection. Treatment varies by the type and severity of the infection but can generally be handled non surgically with antibiotics and antifungal medications. In severe cases surgery can be conducted to cleanse the wound and remove infected tissues.

Osteomyelitis

Osteomyelitis is the medical term for an infection of the bone. Once considered untreatable Osteomyelitis is now curable through surgery and strong antibiotics Often found in the vertebrae of adults the dead bone is removed surgically and followed by antibiotics given intravenously for six weeks.

Symptoms include:

  • Pain in the area of the infection
  • Swelling, warmth and redness over the area of the infection
  • Fever or chills

Ways to Alleviate Pain From Scoliosis

Pain is not a symptom of scoliosis except for rare adult cases. Back pain in an individual with scoliosis is a symptom of another medical issue and should be addressed by a healthcare professional.

Places to Get Help

Get excellent bone and joint treatment from the top doctors at OrthoArizona – Arizona Orthopaedic Associates.

Support Groups

There are a large number of support groups for those suffering with scoliosis both nationally and locally.

Curvy Girls
www.curvygirlsscoliosis.com/

Daily Strength
www.dailystrength.org/c/Scoliosis/support-group

Scoliosis Association
Phoenix
Arizona Public Service Building (APS)
400 North Fifth Street, Conference Room 2 South
Phoenix, AZ 85004
Contact: Carol Lytle
Tel. (480) 839-9822