What you need to know about scoliosis
Contrary to what you might think, scoliosis is not a disease but a musculoskeletal disorder resulting in an abnormal lateral curvature of the spine. The disorder affects about three out of every 100 people, or an estimated six to nine million people in the United States.
The spine is typically straight, but in cases of scoliosis, the spine has an abnormal, sideways curvature. This may be a single curve to the left, like the letter C, or a single curve to the right, like a backwards letter C. In some cases of scoliosis, the spine has two curves, giving it an S-shape.
Though it can develop in infancy or early childhood, most cases of scoliosis develop when the individual is between 10 and 15 years of age. Scoliosis is not more prevalent in one gender over the other, but women and girls are more likely to develop a serious curve requiring treatment.
What causes scoliosis?
Scoliosis may or may not have a particular cause, and for many people, it does not cause problems. The most common cause of scoliosis in adults is degenerative, or wear and tear of the joints of the spine. The disorder may also be congenital, resulting from an embryological malformation of one or more vertebrae, or it may be neuromuscular, associated with cerebral palsy, muscular dystrophy, spina bifida or another type of neurological or muscular disease.
What are the signs and symptoms of scoliosis?
There are several signs that may be an indicator of scoliosis. If you notice one or more of these signs in yourself or your child, schedule an appointment with your primary care provider.
- Uneven shoulders, one or both shoulder blades sticking out
- Head not centered above the pelvis
- One or both hips raised or unusually high
- Rib cages at different heights
- Uneven waist
- Leaning to one side
- Changes in appearance of skin over the spine (dimples, hair patches, color abnormalities)
How is scoliosis diagnosed?
Scoliosis can be confirmed by a doctor through a physical exam, an X-ray, spinal radiograph, CT scan or MRI. The spinal curve is measured by the Cobb Method and diagnosed in terms of severity by the number of degrees. A curve is considered significant if it is greater than 25 or 30 degrees, and is considered severe if it exceeds 45 or 50 degrees.
What treatments are available for scoliosis?
How scoliosis is treated depends on a number of factors, including: spinal maturity, degree of curvature, location of the curve and possibility of curve progression. After assessing these variables, the treatment options that may be recommended include:
Observation: In many cases of pediatric scoliosis, the curve is not significant enough to require treatment, and is instead monitored by the child’s physician every four to six months. Mild cases of scoliosis in adults generally require an X-ray every five years, unless symptoms progress.
Bracing: This option can be effective if the patient has not reached skeletal maturity and the curve is between 25 and 40 degrees. A brace may be prescribed to prevent the curve from progressing and should be worn until the patient has stopped growing.
Surgery: In most cases, surgery is only recommended if the spinal curve is greater than 40 degrees and there are signs of progression, or if the patient has nerve damage to their legs and/or is experiencing bowel and bladder symptoms. Surgery can be considered for patients with a severely painful curvature that has not been relieved with non-operative treatment.
Surgery often involves the fusion of two or more bones in the spine, and may include placement of a metal rod or other implant device to help the body stay in proper alignment. Surgical advancements over the years allow for minimally invasive surgical treatment in some cases of scoliosis.
Other treatments that have not been shown to prevent curves from progressing but which may help alleviate some discomfort and other symptoms include chiropractic treatment, electrical stimulation, nutritional supplements and exercise.
If you are experiencing signs of scoliosis or have been diagnosed with scoliosis, contact Dr. Kushwaha today to learn more about your treatment options.