Scoliosis

What is Scoliosis?

Scoliosis is a condition of side-to-side spinal curves. On an x-ray, the spine of a person with scoliosis looks more like an “S” or a “C” than a straight line. These curves can make the person’s shoulders, hips or waist appear uneven. In scoliosis, the spine’s vertebrae may also be rotated, causing one shoulder blade or trunk muscles to be more prominent than the other.

Scoliosis does not result from carrying heavy items, sports, poor posture, or minor leg length abnormalities. In fact, in more than 80 percent of scoliosis cases, a specific cause is not known. Such cases are termed idiopathic (meaning of undetermined cause), and they are most commonly found in adolescent girls.

• Infantile idiopathic scoliosis is found in children ages 0 to 3.
• Juvenile idiopathic scoliosis is found in in children ages 4 to 10.
• Adolescent idiopathic scoliosis is found in adolescents ages 11 to 18.
• Adult idiopathic scoliosis is found in patients older than 18.

Less often scoliosis develops in those diagnosed with other conditions.

• Neuromuscular scoliosis is associated with diseases like cerebral palsy (CP), spinal muscle atrophy (SMA), Angelman syndrome, Arnold-Chiarimalformation/syrinx or trauma to the spinal cord.
• Syndromic scoliosis is related to other diseases:
  • Myopathic (muscular system-related) disorders like muscular dystrophy, poliomyelitis, arthrogryposis or spinabifida;
  • Connective tissue diseases (Marfan syndrome and Ehlers-Danlossyndrome);
  • Genetic conditions (osteochondrodystrophy [dwarfism], Noonansyndrome, neurofibromatosis), and certain syndromes related to multiple birth defects like VATER syndrome.
  • Learn more about this type of scoliosis and treatments here.

Evaluation: Do I Have Scoliosis?

Doctors can detect scoliosis by performing a physical examination of your back:

1. You stand in a relaxed position with your arms at your sides and the doctor will view you from behind looking for curvature of the spine, shoulder blade asymmetry, waistline asymmetry and any trunk shift.
2. You will also bend forward at the waist to allow the doctor to observe the rotation of the the spine; scoliosis can create a rib prominence in the upper back and/or a flank or waist prominence in the lower back.

• If scoliosis is suspected following this simple examination, the doctor will usually order X-rays of the entire spine from the neck to the pelvis (back and side views).
• If scoliosis is present, the doctor will measure the spine’s curves and provide you with a number, in degrees, to help describe the scoliosis.
• Once the presence of scoliosis is confirmed, your doctor will discuss treatment options with you or refer you to a specialist. Treatment options may include:
  • Routine monitoring of the curvature (and in some case, physical therapy) as long as it remains minimal;
  • Wearing a brace to try to stop the curve(s) from progressing;
  • Surgery for patients with major curves causing discomfort or other health problems.
• To find out more about potential treatment options, follow the link to specific types of scoliosis.