Scoliosis curves can occur at multiple levels of the spine, such as the cervical (neck), thoracic (ribs), and lumbar (lower back) region, even in the same individual. Rarely are two scoliosis patients’ spines identical.
Causes of Scoliosis
The causes of scoliosis are not well understood, and hence prevention and curative treatments are difficult. The best prognosis is when it is caught early in young children, where a back brace or surgical interventions can have beneficial results.
The overwhelming number (80-85%) of cases are “idiopathic scoliosis,” where the cause is unknown. Idiopathic scoliosis is divided into subcategories – infantile, juvenile, adolescent, or adult – depending on the stage of life in which the onset occurred.
Another possible cause is gradual, age-related deterioration (osteoporosis) to the spine, usually in adults. This is referred to as “degenerative” scoliosis.
In 20% of cases, the cause is evident. Here scoliosis is further classified as congenital or neuromuscular. Congenital scoliosis is caused by vertebral abnormalities that affect the embryo in the womb, and may also damage other organs.
Neuromuscular scoliosis is usually a secondary symptom of conditions such as muscular dystrophy (genetic muscle weakness), or cerebral palsy (a type of brain/nerve damage).
Syndromic scoliosis is when a pattern of symptoms occurs. Different conditions can cause syndromic scoliosis:
Marfan syndrome affects the development, growth, and efficacy of connective tissues. This a genetic disorder, traceable to at least one parent with the same condition.
Rett syndrome is a rare genetic, neurological disorder which mostly affects girls. The condition causes severe mental and physical disabilities. There is no cure as of yet, and treatment protocols are stringent and financially draining. Most cases are fortunately detected in early childhood, improving prognosis, treatment options, and life expectancy.
Neurofibromatosis is another genetic condition where tumors start to develop and grow on the nerves. Both benign and malignant tumors can affect the growth and curvature of the spine and cause scoliosis.
Spina bifida is a congenital disability that impacts the closing of the backbone around the spinal cord, often resulting in scoliosis. Scoliosis and its three subtypes – spina bifida occulta, meningocele, and myelomeningocele all affect the lower back, but also rarely the neck.
Scoliosis Signs and Symptoms
Signs and symptoms present themselves as the back starts to change in appearance:
· One shoulder may be higher.
· The spine may curve.
· One hip is more prominent.
· Clothes don’t hang properly.
· The ribcage becomes prominent.
· One leg is shorter.
These symptoms are often accompanied by back pain, especially among adults.
Treatment for Scoliosis:
Anyone can develop scoliosis at any age, although it is more common between 10 and 15 years of age. Scoliosis is also more common among females.
The right plan of treatment will be devised in consultation with your doctor depending on age, diagnosis, and prognosis. In very young children, treatment may be deferred, as the developing spine may straighten out naturally with age. If treatment is required, the patient may be prescribed a brace or cast, thereby forcing the spine to grow straight.
If these do not prove effective, surgery may be recommended, where metal rods placed in the back stabilize the spine. These rods need to be replaced as the child grows.
In older children the scoliosis is less likely to improve. Treatment depends on the prognosis.
Common forms of treatment include:
· Wearing a back brace until the child has stopped growing, preventing further curvature.
· Spinal surgery to correct the curvature by using rods, wires, hooks, and/or screws.
If the patient is an adult, treatment will focus on pain relief. This includes exercise and over the counter or prescription pain medication. Correctional surgery is the last resort.
If you notice any scoliosis signs and symptoms, or have a family history, you must seek medical assistance. Call the Spine Academy of Orthopaedic Associates of Central Maryland today, at (410) 644-1880, or request an appointment online.