Scoliosis: a wavy, curvy bend to the back

Your spine is a collection of 33 bones that have a number of natural curves built into them. Along your neck is the cervical curve of the spine, and along your lower back is the lumbar curve. These curves are subtle and natural, and they do not often cause pain.

Scoliosis is the abnormal curvature of your spine into a C shape or S shape form. This spinal curve is to either the left or the right, and deforms your spine out of shape, sometimes causing pain and other disease processes. About 2 percent of the population has scoliosis, and you are much more likely to have it if someone in your family has it as well. It is much more common in girls than in boys, and it is more likely to occur in childhood than an adulthood. Most of the time, scoliosis requires no treatment. However, sometimes medical attention is needed to correct the abnormal curvature.

What to look for: when is a scoliosis curve more than a curve?

Since scoliosis is a condition commonly diagnosed in childhood, it is important for parents to be aware of the signs and symptoms at an early age. Some signs for parents to watch out for include uneven shoulders, one shoulder blade sticking out more than the other, an uneven waist, one hip elevated higher than the other, and a tendency to lean to one side. Many schools now do scoliosis screenings to catch this disease before it becomes a major problem. Signs of severe scoliosis include back pain and difficulty breathing. You may begin noticing the signs right around puberty because this is when the growths spurts starts and the bones begin to curve. If you suspect that your child has scoliosis, it is important to get them screened by pediatrician as soon as possible so that their back condition can be evaluated for possible intervention.

Too much of a good thing: dangerous side effects of scoliosis

Most scoliosis is mild and does not require any treatment. The curvature of the spine is not enough to need any bracing or surgery, and it does not cause any pain or any other impingement on your child's lifestyle. This type of benign scoliosis is watched for any signs that it may get worse. However, scoliosis that is moderate to severe can cause back pain in later life and severe arthritis of the spine. This is especially true if the scoliosis is left untreated. In severe cases, the ribs are pulled so far out of alignment that they interfere with the functioning of the heart and lungs. This can lead to such things as pneumonia, lung infection, and damage to the heart.

Braces and surgery: treating scoliosis

If your doctor or orthopedist suggests that the scoliosis is bad enough, you may need to look into bracing or possibly surgery for scoliosis. The decision to use a brace is based on a number of factors. Girls more often than boys are braced because girls tend to have more severe scoliosis. A larger curve is more likely to get worse with time and is more likely to need a brace, and S shape curves are more likely to need braces because they tend to get worse over time as well. Also, curves behind the rib cage tend to need bracing. There are two types of braces. One is a low-profile brace that fits underneath the clothing and comes to just underneath the arm pit. The other is the Milwaukee brace that comes up to underneath the jaw. This braces only used in extreme circumstances since it can often cause emotional distress for the child. Although braces are helpful to prevent the progression of scoliosis, they cannot reverse the scoliosis that already exists. For this, surgery is necessary. Spinal fusion is the surgery of choice for scoliosis. In this surgery, the vertebra, or bones of the back, are surgically bound together so that they cannot move against each other. Back stiffness is a side effect of this surgery, but it does correct the curve of the spine.

References:

• Mayo Clinic; Scoliosis
• American Academy of Orthopedic Surgeons; Scoliosis; July 2007

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