What is scoliosis?
Normally, the spine is straight when viewed from the front or back, but in people with scoliosis, it curves to one side.
A curvature of more than 10 degrees is termed scoliosis.
It can lead to the trunk and shoulders no longer being symmetrical. Sometimes the shoulders aren’t level anymore. Sometimes the head is not level, or the pelvis is not level. The rib cage can also push out on one side to become prominent- known as a rib hump. The severity of the abnormalities can vary between people and can change with time.
Scoliosis is described in terms of the location of the curve's apex (cervical, thoracic, thoracolumbar, lumbar) and the side of the convexity of the curve (right or left). Curves may either be single or multiple.
How does scoliosis present?
Scoliosis can present in different ways depending on the severity and location of the spinal curvature. Some common signs and symptoms of scoliosis include:
- Uneven shoulders: one shoulder may appear higher or more prominent than the other.
- Uneven waist: the waistline may appear uneven or have a noticeable curve.
- Leaning to one side: the person may lean to one side when standing or walking.
- Prominent rib cage: a visible bulge or hump may appear on one side of the rib cage.
- Back pain: scoliosis can cause back pain, especially in the lower back.
It's important to note that some people with scoliosis may not experience any symptoms, while others may have more noticeable signs of the condition.
Why does scoliosis matter?
Assessment by a specialist is crucial to determine if scoliosis is a potential issue or if it may become problematic in future.
In most cases, simple investigations and monitoring over time are sufficient. In many cases, no more than observation is required, and individuals can lead normal lives with scoliosis.
However, changes in shape can cause individuals to feel awkward and self-conscious about their appearance. Growth spurts can also result in changes in curvature.
If scoliosis worsens, it can affect spine mechanics, leading to discomfort or pain. In some cases, scoliosis that develops early in life can impact lung development and function, which requires treatment or monitoring. Although rare, scoliosis that starts in childhood or adolescence can result in wear and tear changes that cause pain or nerve pressure later in life. Scoliosis that begins later in life is typically due to wear and tear and can often result in pain and nerve pressure.
What causes scoliosis?
Scoliosis is classified according to the cause:
- Idiopathic: Idiopathic scoliosis is the most common form and has no known cause. It typically develops during childhood or adolescence and affects girls more often than boys. Genetic factors may be responsible as it tends to run in families.
- Congenital: secondary to abnormal fetal development like a malformation.
- Neuromuscular: Cerebral palsy, poliomyelitis, and muscular dystrophy can affect nerve and muscle function leading to scoliosis.
- Injuries, tumours and infections
Early onset scoliosis (EOS) is defined as scoliosis that develops before ten years of age.
Treatment for paediatric scoliosis
The treatment for scoliosis depends on the severity of the condition and several other factors, such as the patient's age, the location of the curve, and the underlying cause.
Treatment options can range from observation and monitoring to surgery:
- Observation and monitoring: In mild cases of scoliosis, where the curvature is less than 25 degrees, the doctor may recommend observation and monitoring without any specific treatment.
- Bracing: Bracing is an option for moderate cases of scoliosis, where the curvature is between 25 and 45 degrees. The brace is designed to halt the progression of the curve and is typically worn for 16 to 23 hours a day.
- Physical therapy: Physical therapy can help improve posture and strengthen the muscles around the spine. This can help reduce pain and discomfort associated with scoliosis.
- Surgery: Surgery may be recommended in severe cases of scoliosis, where the curvature is greater than 45 degrees and is progressing rapidly. The goal of surgery is to correct the curvature and prevent it from getting worse. Surgery typically involves the insertion of metal rods, hooks, and screws to straighten the spine.
It's important to note that the treatment for scoliosis is individualised, and the decision to pursue a particular treatment option depends on several factors, including the severity of the condition, the age of the patient, and the presence of any underlying medical conditions.
Discover a surgical solution for Paediatric Scoliosis:
Paediatric Scoliosis Correction: A procedure aimed at correcting the abnormal curvature of the spine in children.
Need to know more?
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Treatment for degenerative scoliosis