What does the normal spine look like?
When looking directly at the back, the normal spine is in a straight alignment. When viewed from the side, the spine has three normal curves.
What is scoliosis?
When looking at the back, scoliosis is an abnormal side to side curvature of the spine. In a person with severe scoliosis, the spine can resemble and “S” or “C” shape.
Are there other abnormal curves of the spine?
- Kyphosis or roundback is an exaggerated upper back curve.
- Lordosis or swayback is an exaggerated lower back curve.
- Sometimes a person with scoliosis may also have kyphosis or lordosis.
What causes scoliosis?
Most curves, about 80%, have no known cause and are called idiopathic. Some curves are inherited while others are the result of an accident or disease. During the teenage years, scoliosis is more common in girls than boys.
How is scoliosis detected?
- Scoliosis can be observed by family members. Signs may be an uneven hem line in clothing, a noticeable curve when the child is in a bathing suit, clothes not fitting properly or an elevated shoulder. Some children may report back pain.
- School screening is routinely done by the majority of schools in Minnesota. Screening involves the school nurse observing the child’s back from different angles. If the nurse notices any change from the normal spine curves, parents will receive a notice directing them to contact their physician or an orthopaedic surgeon for further evaluation of the curve.
- Scoliosis may also be noted by your own physician during a regular office visit or check up.
Is scoliosis treatable?
Treatment depends on the severity of the curve and the child’s age. The earlier scoliosis is detected, the more treatment options are available. All changes from the normal spinal curves should be checked by a physician. Physical examination should include assessing the child’s back and possible x-rays. There are currently three types of treatment for scoliosis.
- Observation – The physician observes the child’s back over a period of time to determine if the curve increases with growth. X-rays are routinely done in addition to the physical examination.
- Braces – Braces prevent additional curving of the spine, but will not restore the spine to straight alignment. Braces are used while the child is still growing and for small spine curves. When wearing the brace, children are able to participate in many activities. The TLSO brace and Milwaukee brace are examples of two types of braces.
- Surgery –
Surgery straightens the curved portion of the spine as much as possible and holds it in place. Spinal fusion is a type of surgery frequently done to correct scoliosis. Spinal fusion welds the spine together and decreases the amount of the curve. Spinal instrumentation is inserted along the spine, which help the bone grow together by holding the spine in place. Surgery is done on severe curves which continue to progress despite bracing.
Can scoliosis be prevented?
No, but early detection and treatment are important in preventing long term effects of scoliosis on other body systems. In 80-95% of scoliosis patients, surgery may be avoided if treatment is started when the abnormal spinal curve is small and while the child is still growing.
Do adults have scoliosis?
There are two types of scoliosis which occur in adults. Scoliosis can develop as a result of osteoporosis or arthritis, or it can begin after bone growth has stopped. More commonly, scoliosis begins in childhood but the curves continue to progress in adulthood, despite various treatments. Potential problems for adults with scoliosis include back pain, increased stress to the heart and disabling lung disease. Many adults undergo surgery to prevent further complications and deterioration of these body systems. Research studies are being conducted to study the cause of scoliosis and to find the best treatment approach.
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