The abnormal curvature of the spine is a condition known as scoliosis of the spine. Though there is no known, definitive cause for scoliosis, its presence may be congenital or due to a secondary condition which may contribute to its development, such as cerebral palsy. Treatment for scoliosis of the spine is dependent on the individual and the extent of the curvature. Options for treatment may include surgery, which carries some risk. All options should be discussed with a health care professional prior to treatment.
Cases of scoliosis of the spine which have an unknown origin are designated as idiopathic scoliosis and generally manifest in adolescent girls. In some cases, scoliosis can be a congenital condition, meaning it is present at birth, and may be due to the impaired development of the spine while in utero. The presence of a spinal curvature is rarely found in infants or young children, with most cases affecting adolescents entering, or in the midst of, a growth spurt. Other conditions linked to the development of scoliosis of the spine include neuromuscular conditions, which adversely affect an individual’s muscular strength and muscle control, and disease-induced paralysis resulting from disorders such as cerebral palsy and muscular dystrophy.
Individuals who exhibit shoulders, hips or a pelvis that are asymmetrical, or uneven, may be in the early stages of developing scoliosis. Those who regularly experience low-back pain, are easily fatigued, or develop the appearance of a rounded back may also be symptomatic. Since physical symptoms may not be obvious, an early diagnosis may be made during a routine physical examination by a trained physician.
There are several tests which can confirm the presence of scoliosis of the spine. Imaging tests, such as magnetic resonance imaging (MRI), traditional X-ray, and a computerized tomography (CT) scan, may be utilized to create a detailed picture of the spine and surrounding soft tissues. The pictures created using these methods are valuable in not only evaluating the condition of the individual’s spine, but for confirming or ruling out the presence of a secondary condition, such as a tumor. Additionally, a device called a scoliometer is employed to measure the extent, or severity, of the curvature of the spine.
Children with scoliosis who develop a mild curvature, considered less than 20 degrees, generally do not need the assistance of bracing or surgical treatment. Those whose curvature becomes more severe, measuring 25 degrees or greater, may undergo treatment to prevent further curvature and complication. Any treatment decision is dependent on a number of factors, including the extent, location, and pattern of the curve. Additionally, the individual’s gender and overall health are considered before committing to any treatment regimen.
Individuals who are still maturing may be fitted with an adjustable brace, which is generally worn 24 hours a day. Considered a treatment and not a cure, the effectiveness of bracing is dependent on how long it is worn. The use of bracing usually does not hinder a child’s ability to participate in activities, though care should be taken to avoid injury. Bracing is generally discontinued once the child’s bones cease to grow, which usually occurs following puberty. Two common types of bracing include a low-profile brace that allows for more freedom of movement, referred to as a thoracolumbosacral orthosis (TLSO), and a more restrictive, full-torso brace known as the Milwaukee brace, which may be used in cases of severe curvature.
Surgical correction for scoliosis of the spine is generally reserved for more severe cases which progress with time. Known as a spinal fusion procedure, surgical correction involves the fusion of two or more vertebrae reinforced with the implantation of metal rods utilized to straighten the spine. The back is braced for a period of time to allow for the fusion to heal, during which time the individual’s movement may be severely restricted. Complications associated with this procedure include nerve damage, infection, and excessive bleeding.
Since it tends to be hereditary, individuals with a family history of scoliosis of the spine may be at a greater risk of developing the condition. Adolescents are at an increased risk for developing milder forms of scoliosis of the spine, though with maturity this risk decreases. Complications associated with this condition include the development of respiratory and cardiovascular damage resulting from pressure created by the curvature. Individuals with persistent symptoms associated with scoliosis may experience chronic back pain and may develop spinal inflammation, or arthritis.