Scoliosis

What Is Scoliosis?

Scoliosis is a sideways curve in your backbone (or spine). Often, it first shows up when you're a child or teenager.

The angle of the curve may be small, large, or somewhere in between. But anything that measures more than 10 degrees on an X-ray is considered scoliosis. Doctors may use the letters "C" and "S" to describe the curve.

Signs and Symptoms of Scoliosis

If you have scoliosis, you might lean a little when you stand. You could also have:

• A visible curve in your back
• Shoulders, a waist, or hips that look uneven
• One shoulder blade that looks bigger
• Ribs that stick out farther on one side of your body than the other

In addition to visible symptoms, scoliosis may lead to:

• Low back pain
• Back stiffness
• Pain and numbness in your legs (from pinched nerves)
• Fatigue due to muscle strain

Scoliosis Diagnosis

To check for scoliosis, your doctor might first ask you to bend over from the waist so they can see if your spine looks curved. Pediatricians often do this kind of exam on children.

If your back looks curved, they'll likely do an X-ray to see whether it's scoliosis. Your doctor might also do an MRI to rule out things like a tumor that could cause your spine to curve.

Types of Scoliosis

Idiopathic scoliosis is scoliosis without a known cause. In as many as 80% of cases, doctors don’t find the exact reason for a curved spine.

Congenital scoliosis begins as a baby’s back develops before birth. Problems with the tiny bones in the back, called vertebrae, can cause the spine to curve. The vertebrae may be incomplete or fail to divide properly. Doctors may spot this rare condition when the child is born. Or they may not find it until the teen years.

Neuromuscular scoliosis is caused by a disorder like spina bifida, cerebral palsy, or a spinal cord injury. These conditions sometimes damage your muscles so they don’t support your spine correctly. That can cause your back to curve.

Degenerative scoliosis affects adults. It usually develops in the lower back as the disks and joints of the spine begin to wear out as you age.

Scoliosis Causes and Risk Factors

Some kinds of scoliosis have clear causes. Doctors divide those curves into two categories -- structural and nonstructural.

In nonstructural scoliosis, the spine works normally but looks curved. This happens for a number of reasons, such as having one leg that's longer than the other, muscle spasms, and inflammations like appendicitis. When these problems are treated, the scoliosis often goes away.

In structural scoliosis, the curve of the spine is rigid and can’t be reversed.

Causes include:

• Cerebral palsy
• Muscular dystrophy
• Birth defects
• Infections
• Tumors
• Genetic conditions like Marfan syndrome and Down syndrome

For idiopathic scoliosis, family history and genetics can be risk factors. If you or one of your children has this condition, make sure your other kids are checked regularly.

Scoliosis shows up most often during growth spurts, usually when kids are between 10 and 15 years old. About the same number of boys and girls are diagnosed with minor idiopathic scoliosis. But curves in girls are 10 times more likely to get worse and may need to be treated.

Scoliosis diagnosed during the teen years can continue into adulthood. The more your spine is curved, the more likely it is to get worse over time. If you had scoliosis in the past, have your doctor check your back regularly.

Scoliosis Treatment

For mild scoliosis, you may not need treatment. Instead, your doctor might watch you and take X-rays once in a while to see if it's getting worse. Some children grow out of scoliosis.

If you or your child need treatment, your doctor might suggest:

• Braces. In kids who are still growing, wearing a brace around your torso can stop the curve from getting worse. They're usually made of plastic. Many kids wear them 24 hours a day. You can't see them under clothes, and they don’t stop you from doing everyday activities.
• Spinal fusion surgery. In this operation, your doctor puts pieces of bone or a similar material between bones in your spine. They use hardware to hold the bones in place until they grow together, or fuse. The surgery can lessen the curve in your spine as well as keep it from getting worse.
• Spine and rib-based growing operation. This is done to correct more serious scoliosis in children who are still growing. The doctor attaches rods to your spine or ribs with hardware. As you grow, the doctor adjusts the length of the rods.

Scoliosis Prevention

There's no way to prevent scoliosis. So forget the rumors you may have heard, such as childhood sports injuries causing scoliosis.

Likewise, if your kids are in school, you may be concerned about the weight of the textbooks they carry. While heavy backpacks may cause back, shoulder, and neck pain, they don’t lead to scoliosis.

And what about poor posture? The way a person stands or sits doesn’t affect their chances for scoliosis. But a curved spine may cause a noticeable lean. If your child isn’t able to stand upright, ask your doctor to look at their spine.

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