Scoliosis: Know the Facts

Scoliosis is a sideways curvature of the spine, in which the spinal column can also twist, pulling the ribcage out of position. Although many people have not heard of the condition it is surprisingly common in the general population, especially in the early adolescence, but it is only severe enough to need hospital supervision in about three of every 1000 teenagers.

Having scoliosis means that in an otherwise healthy person the spine is twisted or curved. It is not infectious or contagious and it does not develop as a result of anything the adult, child or its parents did, or failed to do.

Most cases of scoliosis have no known cause, and are labelled idiopathic scoliosis. The remaining cases of scoliosis can be attributed to neuromuscular conditions, such as muscular dystrophy or cerebral palsy, are syndromic (e.g. Marfan's Syndrome), are caused by degeneration of the spine in old age, or occur at birth.

If a person with scoliosis bends forward, a clear rib bulge will be visible from behind. Sometimes one shoulder blade is also more prominent than the other, or the hips can be uneven.

The earlier the scoliosis is detected and treated, the better for the patient. Left untreated, scoliosis could potentially worsen, and in serious cases could cause side-effects such as damaged lung function or physical disabilities.

Who is affected?

Scoliosis can affect people at different points in their lives. It can occur before birth (congenital), in infants and children (early onset), adolescents (late onset) and as adults (degenerative or de novo).

Infants and Children

Scoliosis can develop before birth and is caused by a defect in the formation of the spinal column; this is called congenital scoliosis. It can also occasionally develop in infants and children between the ages of 3 and 10 years (early onset idiopathic scoliosis), for no known reason. A baby or child in whom a curve is detected should be regularly monitored by X-Ray to see whether the curvature progresses or resolves. Since curves can increase rapidly (as mine did), referral to a specialist should be prompt. Treatment can mean a period in a body plaster cast (my fitting in March 1989), and can result in permanent correction of the curve in very young children. Scoliosis can also occur as a secondary condition of neuromuscular conditions or as part of a syndrome.

Adolescents

In this age group, scoliosis affects more girls than boys, in a ratio of 6:1 and is called late onset idiopathic scoliosis. Scoliosis curves are usually noticed for the first time at age 10-14 years (I was diagnosed and operated on at the age of 12), often by a friend, a teacher, or on the beach. Scoliosis is most common in this age group and often worsens with the growth spurt that occurs during adolescence. Therefore, a teenager who is diagnosed with scoliosis should be seen by a specialist unit, their spine will be X-Rayed in several positions. Treatment should not be delayed by more than a few months, to avoid the possibility of deterioration.

Adults

Degenerative scoliosis occurs in adults for two main reasons. First, scoliosis may have started when the patient was younger and gone undetected, or it may have developed before modern surgical techniques were available and has slowly worsened in adult life. The second degenerative (also known as de novo) type of scoliosis starts after the age of 40 years. It is thought to be the result of arthritis or degeneration of the discs and the facet joints, particularly if the patient has osteoporosis. These curves might also progress a few degrees per year. Depending on the individual, surgery can be an option, but considerations are greater because of low bone density, rigidity of the curve, and complications.

SAUK