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Scoliosis

What Is Scoliosis?

Scoliosis is a condition in which the spine curves to the side in an S or C shape. Scoliosis can occur at any age, but it is most diagnosed in children and adolescents during growth spurts. The cause of scoliosis is often unknown, but it may be related to genetic factors or other underlying conditions such as cerebral palsy or muscular dystrophy. Scoliosis can cause problems with posture and balance, and it can also lead to pain and difficulty with physical activities. Treatment options may include observation, physical therapy, bracing or surgery, depending on the severity of the curvature and the age of the person.

Types of Scoliosis

There are different types of scoliosis that can be broken down into categories. The largest being idiopathic scoliosis, a term used to refer to cases where the cause is unknown. Within that category, idiopathic scoliosis is broken down by age, the most common of these being adolescent scoliosis:

  • Infant: 0 - 3 years
  • Juvenile: 4 - 10 years
  • Adolescent: 11 - 18 years
  • Adult: 18+ years

When a cause can be determined, it will fall under two categories:

  • Congenital scoliosis - Where spinal deformities are present from birth.
  • Neuromuscular scoliosis - When nerve malfunctions affect the muscles and spine.

Scoliosis is also categorized into structural or nonstructural, referring to the treatability of scoliosis.

  • Structural – The spinal curve abnormality was caused by disease, injury or birth defect, and is untreatable.
  • Nonstructural – This is a temporary abnormality of the spine and can be fixed.

What Causes Scoliosis?

The root cause of many cases is undetermined. Most commonly it arises as a result of a growth spurt during puberty that causes an abnormal growth pattern or curve progression. It can also be a symptom of conditions such as muscular dystrophy and cerebral palsy.

Other factors may include:

  • Birth defects
  • Neurological disorders
  • Genetic conditions

What Are the Symptoms of Scoliosis?

Symptoms will vary depending on the cause and degree of scoliosis, but common symptoms may include:

  • Uneven shoulder blades
  • One shoulder blade that protrudes outward and one that does not
  • Uneven hips
  • Rotation in the spine
  • Problems breathing because of unnatural pressure on the chest and lungs
  • Chronic back pain

How Is Scoliosis Diagnosed?

Your diagnosis of scoliosis will begin with a comprehensive medical exam and will likely also include an imaging test. CT scans may be performed to look for abnormalities in the spine and surrounding soft tissue. MRI scans are also common, offering a more detailed view of the spine.

Scoliosis Treatment

Types of treatment will depend on several factors. The degree of which the spine is curved or damaged being the major factor. Other factors include:

  • Age
  • Potential for more growth (in juvenile and adolescence cases)
  • The type of curvature
  • The type of scoliosis

The most common treatment options are bracing and surgery.

Bracing

A scoliosis brace may be used if there is still potential for growth or if a spinal curvature is severe. Braces will not reverse curvature but they can prevent the spine from curving further. Doctors generally recommend juvenile cases reach adolescence before bracing.

There are two types of braces used in the treatment of scoliosis.

  • Underarm – A brace that wraps around the torso to promote good posture and prevent slouching or uneven posture.
  • Milwaukee – The original brace developed for scoliosis in the 1940s. Similar to the underarm brace but bulkier and much taller. Rarely used unless a case is severe or if curvature in higher on the spine.

Surgery

Scoliosis surgery  is recommended for people with severe curvature that is greater than 40 degrees. Surgery may also be used if the symptoms are dangerous or if they are interfering with daily life.

Spinal fusion is the surgical procedure most often used to treat scoliosis. This procedure removes soft tissue between vertebral bones and replaces it with bone or metal. The two bones, over time, fuse to form one long bone. Another method of spinal fusion surgery is fusing vertebrae together using bone grafts, rods and screws. A spinal fusion will most likely require a hospital stay and will likely cause some activity restrictions for three to twelve months.

Ongoing Care for Scoliosis

Long term care will depend on the degree of curvature and the spine’s reaction to treatment. Long-term symptoms that are mild may not interfere with everyday activities.

With the right treatment plan and a healthy lifestyle, symptoms can be greatly reduced to allow for normal functioning of the spine.

At Banner Health, we understand that spine conditions can be painful, which is why we bring together a team of experts, including neurologists, neurosurgeons and orthopedic surgeons to treat your individual spine condition.