What is Scoliosis?
Scoliosis is a condition characterized by curvature of the spine. It usually occurs during growth spurt years, just before the puberty.
Scoliosis can be caused by certain conditions like muscular dystrophy and cerebral palsy but the majority of the cases have unknown causes.
Symptoms of Scoliosis
During the early stages of scoliosis, there is a lateral, or side, curvature of the spine of at least 10 degrees. A curve as small as this will not show any signs or symptoms.
As the curve progresses to 20 degrees and more, signs and symptoms like uneven shoulders, waist, and hips (one hip higher than the other) become more obvious.
The progression of the curve may cause other issues like trunk imbalances, muscle spasms, and pain.
To diagnose scoliosis, the doctor has to take a detailed medical history including questions about recent growth. He/she will also do a thorough physical exam which includes the Adam’s forward bend test. In this test, the doctor will ask the patient to bend forward at the waist, with arms hanging loosely. This position allows the doctor to see the asymmetry of the shoulders, waist, and hips. This forward bend test is highly useful for scoliosis in the upper or mid back.
As part of the forward bend test, the doctor may use a special tool called a scoliometer (also known as inclinometer). This tool is placed flat on the back of the patient where the asymmetry looks at its greatest. It helps in estimating the angle of trunk rotation (ATR).
Plain X-rays are often recommended to help confirm the diagnosis. If the doctor suspects of a tumor, additional tests such as MRI scan will be recommended.
How It Is Treated
Most children have mild scoliosis but usually don’t need any treatment. However, they may be required for regular checkups every 4 to 6 months to see if there are changes in the spine.
If the child has moderate scoliosis, he/she may be recommended to wear a brace. Its use won’t cure or reverse the curve but can help in preventing further progression of the curve.
For severe scoliosis, the doctor may recommend surgery to reduce the severity of the spinal curve.
Spinal fusion is the most common surgery for scoliosis. In this procedure, the surgeon connects two or more bones in the spine so they can’t move independently.