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 Scoliosis is a
side-to-side curvature of the spine. It can be caused by congenital,
developmental or degenerative problems, but the vast majority of cases of
scoliosis actually has no known cause.
By far the most common form of scoliosis is idiopathic scoliosis which
develops in adolescents and progresses mostly during the adolescent growth
spurt. The cause of idiopathic scoliosis is unknown (idiopathic literally
means “cause unknown”).
Scoliosis usually develops in the thoracic spine (upper back) or the
thoracolumbar area of the spine, which is between the thoracic spine and
lumbar spine (lower back). It may also occur just in the lower back. The
curvature of the spine from scoliosis may develop as a single curve (shaped
like the letter C) or as two curves (shaped like the letter S).
It is important to note that scoliosis is not typically a cause of back
pain. The condition represents a deformity of the spine but is usually not
painful.
Idiopathic scoliosis is a relatively common disorder and affects
approximately 1 in 1,000 adolescents. It’s categorized into three age
groups, from birth to 3 years old (infant), from greater than 3 to 9 years
old (juvenile), and from greater than 9 to 18 years old (adolescent). This
last category accounts for 80 percent of the cases. Girls tend to be
affected slightly more often than boys. More importantly, girls are eight
times more likely to need treatment for scoliosis, because they tend to
have curves that are much more likely to progress. For both boys and girls,
the risk of curvature progression is increased during puberty, when the
growth rate of the body is the fastest.
Scoliosis is a term used to describe a condition, but is not a disease,
or a diagnosis. Because idiopathic scoliosis is considered a deformity,
treatment is largely centered on reducing or limiting the progression of
the deformity and is not focused on treatment of pain.
Diagnosis
Many cases of idiopathic scoliosis are diagnosed using the Adam’s
forward bend test. Students are routinely given this examination in school
to determine whether or not they may have scoliosis. A physician may also
perform this test as part of a routine physical. The test involves the
patient bending forward with arms stretched downward, while being observed
by a healthcare professional. If a “rib hump” or asymetry is
seen, or if the shoulders are different heights, scoliosis may be
suspected. If so, an x-ray may be ordered to determine the degree of
severity of the curve. In rare cases, especially if the scoliosis may be
causing a problem for the neurological functions of the spinal cord, an MRI
may be ordered so the physician can get a better look at the situation. A
diagnosis of scoliosis does not mean the activity level of the individual
should be restricted, since activity does not affect the degree of the
curve.
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