Scoliosis is a medical condition in which a person's spine is curved from side to side. Although it is a complex three-dimensional deformity, on an X-ray, viewed from the rear, the spine of an individual with scoliosis may look more like an "S" or a "C" than a straight line. Scoliosis is typically classified as either congenital (present at birth), idiopathic (cause unknown), or neuromuscular (symptom of another condition). Scoliosis affects approximately seven million people in the United States. It occurs most often during the growth spurt just before puberty. While scoliosis can be caused by conditions such as cerebral palsy and muscular dystrophy, most scoliosis causes are unknown. Most cases are mild, but severe scoliosis can be disabling. An especially severe spinal curve can reduce the amount of space within the chest, making it difficult for the lungs to function properly. Children who have mild scoliosis are monitored closely with X-rays to see if the curve is worsening. Scoliosis is diagnosed by exam with a physician, who will check to see if a child's back or ribs are even. If the doctor finds that one side is higher than the other, the child may need an X-ray for final confirmation.
Symptoms of Scoliosis
Scoliosis most often causes no symptoms in a child until the spinal curve becomes large. One might notice early signs with close observation. A child may have one shoulder or hip that looks higher than the other. Or the child's head does not look centered over the body. A child could possible have one shoulder blade that sticks out more than the other. The last early sign to watch for is if a child's waistline is flat on one side, or the ribs look higher on one side when the child bends forward at the waist. In adults, scoliosis may cause back pain and trouble breathing, but scoliosis is most serious in young children who are still growing. A curve in the spine may get worse as the child grows, so many experts believe screening for scoliosis is important so that any curvature in the spine is discovered early and monitored closely. A worsening scoliosis curve will also rotate or twist the spine. One should seek medical attention if he or she notices these signs or symptoms of scoliosis in a child. Mild curves can develop without the parent or child knowing it because the change is gradual and is usually painless.
Scoliosis Treatment
Most children with scoliosis have mild curves and likely will not need scoliosis treatment with a brace or surgery. Children who have mild scoliosis may need checkups every four to six months to monitor changes in the curvature of their spines. Though guidelines for mild, moderate and severe curves do exist, the decision to begin scoliosis treatment is made on a case-by-case basis. A physician will consider the child's sex (girls have a higher risk of progression), severity of the curve, curve pattern (S-curves worsen more than C-curves), location of the curvature, and bone maturity. If a child's bones are still growing, a doctor may recommend a brace. This won't cure scoliosis, or reverse the curve, but it can prevent further progression of the curve. Braces are worn day and night and will be discontinued after the bones stop growing. A surgery called spinal fusion may be recommended for severe scoliosis treatment. Spinal fusion connects two or more of the spinal bones (vertebrae) together with new bone. This is accomplished with either metal rods, hooks, screws or wires to hold the spine straight and rigid while the bone heals. The process is similar to the healing of any other broken bone.
