Introduction

Your spine, or backbone, helps hold your body upright. Everybody’s spine has natural curves. A certain amount of curvature is necessary for people to balance, move, and walk properly.

What is scoliosis?

It is a condition that causes the spine to curve too much in the wrong direction. The name comes from the Greek word “skoliosis,” which means crooked. On an X-ray, the spine looks more like an “S” or a “C” rather than a straight line.

Who gets scoliosis?

Children

Infantile scoliosis – In children less than 3 years old. . It may results from a birth defect, disease of the nerves and muscles (such as muscular dystrophy or cerebral palsy), injury, infection or tumors.

Juvenile scoliosis – In children between the ages of 3 and 10 years old. It is not common.

Adolescent

Adolescent idiopathic (cause is unknown) scoliosis – It occurs after the age of 10. This is the most common type.

Adults

Adult scoliosis may represent the progression of a condition that had actually began in childhood, and was not diagnosed or treated while the person was still growing. What might have started out as a slight or moderate curve has progressed in the absence of treatment? It can also be caused by degenerative changes of the spine.

Can also run in families

If someone in a family has scoliosis, the likelihood of an incidence is much higher – approximately 20 percent. If anyone in your family has a problem with the curvature of the spine, he or she should be examined for scoliosis.

Cause

Most of the time the cause is unknown. In some cases it exists at birth due to congenital spinal abnormality. It is not cause by:

• Slouching
• Sitting in awkward positions
• Sleeping on an old mattress

Scoliosis often presents itself, or worsens, during the adolescence growth spurt.

Symptoms

Usually painless in adolescents and young adults. Pain is common in adulthood if left untreated. The most common complaint is cosmetic deformity. Other symptoms can include:

• Uneven musculature on one side of spine
• Prominent shoulder blade
• Uneven hip and shoulder levels
• Location or size of breasts is not symmetrical
• Unequal distance between arms and body
• Clothes do not hang properly resulting in uneven hemlines

If allowed to progress:

• Severe adult scoliosis can lead to chronic back pain, deformity and difficulty in breathing

Treatment

Observation for mild cases or when it is near skeletal maturity.

• Doctors will check the progress to ensure the curve is not progressively getting worse
• You may be asked to come every 3-6 months

Bracing

• The aim is to prevent the curve from getting worse
• Doctors would recommend the appropriate braces

Surgery

• This would be recommended for more severe curvature
• The surgery requires a bone graft from the hip or ribs. A series of rods, hooks, screws or wires are used to straighten the spine
• Following surgery, patients would be able to walk without a brace by the second or third day. They can be discharged from the hospital within a week and, can rapidly resume their daily activities. A return to some sports is possible in 6 to 9 months

Tips for parents for early detection of Scoliosis:

Idiopathic scoliosis can go unnoticed in a child because it is rarely painful in the formative years. Parents should watch for the following “tip-offs” to scoliosis beginning when their child is about 8 years of age:

• Uneven shoulders
• Prominent shoulder blade/s
• Uneven waist
• Elevated hips
• Leaning to one side

If any of the above is present, please bring your child for an examination by the family physician, pediatrician or orthopedic surgeon.