Scoliosis is the lateral, or side to side, curvature of the spine. It may exist in one, two, or more curves. Scoliosis is usually not diagnosed unless the curve is greater than ten (10) degrees in measurment. Scoliosis is most common in girls, but does also exist in some males.
Groups Most Commonly Affected:
Scoliosis usually affects girls in their pre-teen to teen ages (between 10-15 years old). This is because this is the most rapid period of growth in children. In males, scoliosis might develop later on, since the growth spurts during male puberty are much later (i.e. 13-17 years old). Congenital scoliosis, or scoliosis from birth, will affect younger children and may varry depending on the severity of the curvature at each point of the child's life.
Why is it important?
Scoliosis can pose some serious health concerns, as well as social concerns. Usually, since scoliosis most commonly affects teenage girls during their most active social periods of development, looking "diffrent" because of the scoliosis or a brace or so on may make the teen depressed, anit-social, angery, or even suicidle. Besides the mental aspects of scoliosis, it poses more of a physiological risk as well. As the spine curves, space in the chest cavity is reduced. It is much like taking a bendi-straw, pulling it to its fullest length, then bend the top one way or the other. Watching the folding part, it's noticed that the side the top is bending to also closes all the space on the folds in the straw. The same happens in people and their ribs. The curving, if it becomes quite severe, can accually cause high stress levels on vital organs, such as the heart and lungs. If not treated, this could lead to breathing problems or even heart failure.
What can be done?
From most physicians, they will explain that scoliosis patients have three real options to treat their scoliosis. A) Do nothing and see if the curvature stops on its own, B) Use a scoliosis brace for some amount of time to attempt to halt the curve progression, and C) Undergo surgery to halt the progression of the curvature and commonly get somewhat of a correction. Each of these options is explained a little more below.
Do Nothing
If the scoliosis is minimal, the patient may be able to opted for no treatment at that time. Monitoring by check-ups and X-rays on a set schedule by an orthopedic or scoliosis specialist is usually required to make sure that a treatment is not nessissary.
Get a Brace
If the scoliosis is a, sort of say, medium grade curvature, usually between 20-40 degrees*, a brace might be used as treatment. The brace uses force on the patient's body to hold the curved spine in a straighter possision so that any further growth can be straighter. It's a lot like when someone ties a tree that is growing crooked to a post and then the rope or chain is tightened until the tree stands as straight as possible. The brace holds the paithers spine straight while the patient grows.
There are several types of braces. The most common are the Boston/TLSO (thoracolumbosacral orthosis) brace, the Millwaulkee Brace, the Charleston Bending Brace, the Providence Brace, and the Willmington Brace. There are other, more advanced braces comming on the scene now, but these are the most common. To read more about each of these braces and learn more on the whole bracing topic, please click here.
Have Surgery
The most reliable option for treating scoliosis is surgery. This is most commonly accomplished by a procedure called a "spinal fusion". The procedure involves placing instrumentation (rods, screws, hooks, wires, etc.) on the spine to hold it in a strong, still possission. Next, bone from a bone graft (usually from the pelvic, or hip, bone, rib bone, a bone bank, or synthetic material. Over time, the bone fuses to the spine, making it solid to prevent any further curvature. In a lot of cases, the curvature is also reduced, but most patients are reminded that the major purpose of the surgery is to stop the progression of the curve, not so much as to correct the curve.
There are three main spinal fusion procedures. These are sometimes used in conjuction with each other to achive the best possible result. The posterior spinal fusion is the most common. It involves making a long insision down the spine do access the spine. The fusion explained above is then undergone. Normally, two rods are used, one on each side of the spine. The anterior spinal fusion involves going through the side of the patient's chest. The instrumentation is placed on just that side, as is the fusion. However, because the lung must be colapsed to get to the spine, a chest tube is nessissary. The new method is to use a procedure called the "Thorascopic Spinal Fusion", or sometimes it is known as the "Anterior Release". This uses several small insisions in the patient's side and a video camera to do the fusion. The disc's in the patient's spine must be removed for this surgery, and a chest tube must be used as well. Overall, recovery from this surgery is quicker and less painful than the other procedures. To learn more about the surgical procedures, click here.
How is scoliosis detected?
For the most part, scoliosis is detected visually. In most cases past around 15-20 degrees, any scoliosis can be seen on a bare backed person. It is harder to see in a normal curvature level with clothes on because the clothes often can hide the problem. For this reason, scoliosis might be seen by family members or the patient when in a bathing suit or showering.
Besides what I call the "bare back" approach for non-clinical detection, as in by family members, friends, and personally, another thing to look for is any variation in stripes on shirts or or zippers on clothing. If scoliosis exists, a non-vertical/horizonal; patern may be noticed. The curving causes the lines to be crooked, so notice these paterns, and maybe scoliosis can be seen.
A common place for scoliosis to be detected is in a clinical setting. School screening for scoliosis exist nationwide for students in middle school. In these, school nurses or other trained professionals have the students to come into a private room, have the student take his/her shirt off, and have the student stand straight to observe any visual curving from this possission. Next, the student leans forward as in touching his/her toes. This will show a slight hump on one side or the other if scoliosis exists. The same is true during physicals that teenagers have for school, sports, and general health. For school screening, the female students are usually allowed to wear a bathing suit or a hospital gown during the screening to protect their privacy.
Adolescent Scoliosis Society of North America
Designed by: Justin Oswalt
