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Scoliosis

Alternate Names

  • curvature of the spine
  • Scoliosis
  • Site of lumbosacral spine X-ray

Definition

Scoliosis is a condition in which the spine is bent to one side. It can occur in infants and children, but typically develops during adolescence, when growth is most rapid.

What is going on in the body?

The vertebrae, the bones that form the spinal column, are usually aligned straight when viewed from behind. In scoliosis, the spine is bent to the side. The spine can sometimes rotate, causing an uneven rib cage. If this happens, the ribs in the back will be prominent on one side.
Scoliosis is sometimes associated with excess bending forward of the spine, called kyphosis, or with excess bending backward of the spine, called lordosis. The curve of the spine may vary from a C-shaped to a S-shaped pattern.

Risks

What are the causes and risks of the condition?

Scoliosis may be inborn or developmental. The cause is usually unknown. Severe cases are seen more frequently in girls than in boys. Scoliosis is also more common when there is a family history of scoliosis.
Some cases of scoliosis may result from:
  • disease of the nervous or muscular systems
  • bone fracture
  • infection
  • malformed vertebrae
  • tumor of the vertebrae or spinal cord

Prevention

What can be done to prevent the condition?

There is no way to prevent scoliosis.

Diagnosed

How is the condition diagnosed?

Scoliosis is diagnosed based on the signs listed above. A school nurse or physical education teacher can screen students for scoliosis by simply having them bend forward, and looking for asymmetry. Students identified in such a way should be referred to a healthcare professional for further evaluation.
The degree of scoliosis can be determined by making a standard series of measurements on an X-ray film. X-rays may also reveal the cause of the curvature. An instrument called an inclinometer measures the amount of rotation of the rib cage.

Long Term Effects

What are the long-term effects of the condition?

Mild to moderate scoliosis may not cause any problems. More severe scoliosis may cause pain. In advanced cases in which the rib cage or chest is badly rotated, breathing may be difficult.

Other Risks

What are the risks to others?

Scoliosis is not contagious, and poses no risk to others.

Treatments

What are the treatments for the condition?

Observation is appropriate for many mild curves that do not progress. Braces may be used for moderate curves that are progressing, but they are not always effective.
Finally, a spinal fusion operation is recommended for severe, progressive curves. The purpose of this operation is to at least partially correct the curvature if possible. It also fuses or joins together the vertebrae of the curve, usually with metal rods or cables in the back. Scoliosis caused by nervous or muscular system conditions is more likely to progress and require an operation.

Side Effects

What are the side effects of the treatments?

Braces may cause skin irritation. The self-conscious teenager may choose not to wear the brace as recommended, which can reduce its effectiveness. Surgery can be complicated by bleeding, infection, or reactions to anesthesia.

After Treatment

What happens after treatment for the condition?

There may be progression of the curve despite appropriate treatment. In rare cases following operation, the spine may not fuse successfully. This may eventually cause nerve damage with paralysis. In addition, the metal rods or cables in the spine may break, causing the need for their replacement or removal.

Monitor

How is the condition monitored?

It is important to periodically monitor children's spines through exams at school and in the healthcare professional's office, especially during the rapid growth years of early adolescence. Parents might observe their children's exposed backs. Any new or worsening symptoms should be reported to the healthcare professional.

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