Scoliosis

A normal spine, when viewed from behind, appears straight. But a spine affected by scoliosis shows a side-to-side curvature, with the spine looking like an "S" or "C." The back bones (vertebrae) may also be rotated. This makes it look like the person is leaning to one side. Scoliosis is defined as a curvature of the spine measuring 10° or greater.

Scoliosis is not due to poor posture.

Spinal curvature from scoliosis may occur on the right, left, or both sides of the spine. Both the middle (thoracic) and lower (lumbar) spine may be affected by scoliosis.

n most cases, the cause of scoliosis is not known. This is called idiopathic scoliosis. In other cases, scoliosis may be caused by a breakdown of the spinal discs. This can occur with arthritis or osteoporosis. Or it may be a hereditary condition that runs in families.

The abnormal curves of the spine are defined according to their cause, including:

• Nonstructural scoliosis. This is also called functional scoliosis. In this condition, a normal spine is curved due to 1 or more problems. For example, the leg lengths may be different. Or there may be an inflammatory problem. This type of scoliosis is often short-term. It goes away when the underlying problem is treated.

• Structural scoliosis. The possible causes of structural scoliosis include:

  • Unknown (idiopathic scoliosis).

  • Disease that is neuromuscular, metabolic, rheumatoid, or other type.

  • Birth defect.

  • Injury.

  • Infection.

  • Abnormal growth.

These are the most common symptoms of scoliosis:

• Difference in shoulder height.

• Head is off-center from the rest of the body.

• Difference in hip height or position.

• Difference in shoulder blade height or position.

• When standing straight, difference in the way the arms hang beside the body.

• When bending forward, the sides of the back look different in height.

• Weakness, numbness, or shooting pain in extremities.

Get medical care right away if you have back pain, leg pain, or changes in bowel and bladder habits. These are not often seen with idiopathic scoliosis.

The symptoms of scoliosis may look like other health problems. Always see your healthcare provider for a diagnosis.

A healthcare provider will ask about your health history. He or she will give you a physical exam. You will have X-rays. These are the main tool for diagnosing scoliosis. The healthcare provider measures the degree of spinal curvature on the X-ray.

Other tests may be done for non-idiopathic curvatures, abnormal curve patterns, or congenital scoliosis. These include:

• MRI. MRI uses a combination of large magnets and a computer to produce detailed images of organs and structures within the body.

• CT scan. A CT scan uses X-rays and computer technology to make horizontal, or axial, images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.

Early detection of scoliosis is most important for successful treatment.

The goal of treatment is to stop the progression of the curve and prevent deformity. Treatment may include:

• X-Rays. Plain film X-rays can demonstrate a curve caused by scoliosis.

• Observation and repeated exams. This may be needed to determine if the spine is continuing to curve. It is used when a person has a curve less than 25° that is still growing.

• Bracing. Bracing may be used when the curve measures more than 25° to 30° on an X-ray, but skeletal growth remains. It may also be needed if a person is growing and has a curve between 20° and 29° that isn't improving or that is advancing. The type of brace and the amount of time spent in the brace will depend on the severity of the condition.

• Surgery. Surgery may be recommended when the curve measures 45° or more on an X-ray and bracing isn't successful in slowing down the progression of the curve when a person is still growing. Certain symptoms, such as loss of bladder or bowel control, may also require surgery.

There's no scientific evidence to show that other methods for treating scoliosis (for example, chiropractic manipulation, electrical stimulation, nutritional supplementation, and exercise) prevent the progression of the disease. Talk with your healthcare provider before starting, or paying for, a nontraditional treatment for scoliosis.

A serious spinal curve that isn’t treated can get worse as you grow. Over time, it may cause problems. These can include:

• Back pain.

• Arthritis in your back.

• Your body looking twisted.

• Clothes not fitting right.

• Heart and breathing problems (rare).