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What is Scoliosis?

Scoliosis is a fairly-common skeletal abnormality characterised by a three-dimensional curvature of the spine. This curvature presents itself in either an ‘S’-like or ‘C’-like shape. It can present itself at any age, although it is most commonly picked up at youth.

There are four different types of scoliosis, each with varying causes. These are Idiopathic, Neuromuscular, Degenerative, and Congenital. The presence of scoliosis in each individual is unique and may range between mild, moderate, and severe conditions. The curvature that defines ‘scoliosis’ can form in either the lumbar (lower back), thoracic (middle back) or cervical (neck) spine, and in many cases in more than one.

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What causes Scoliosis to occur?

Idiopathic Scoliosis:

For the great majority of scoliosis cases, the origin is idiopathic. This means that the direct cause of the curvature is unknown, even to medical professionals. It has been suggested in medical journals that this type of scoliosis may be hereditary, though there is not enough substantial evidence to support the claim.

Idiopathic scoliosis is often mild and usually doesn’t cause obvious symptoms. It’s often picked up incidentally in the clinic, or during X-ray examinations. Though it can be found in individuals at any age and of any gender, idiopathic scoliosis is most linked closely to female adolescents.

In other instances (when the cause for scoliosis is not idiopathic) the deformity may be as a result of one of the following reasons:

Neuromuscular Scoliosis:

Neuromuscular Scoliosis is caused by an underlying brain, nervous or skeletal system disorder. These include, (but are not limited to), cerebral palsy, muscular dystrophy, and spina bifida. Cases of neuromuscular scoliosis are often moderate to severe.

Degenerative Scoliosis:

Degenerative Scoliosis (also known as late or adult-onset scoliosis), is caused by ageing and the progressive degeneration of the discs, facet joints, and other structural components of the spinal column. It effects mostly elderly people.

Congenital Scoliosis:

Congenital Scoliosis is the least common variation of scoliosis and is caused by bone malformations in the womb during foetal development in pregnancy. Babies who are born with scoliosis are highly susceptible to the curvature worsening as they grow.

Scoliosis in Adolescents

Scoliosis seems to present itself more frequently in adolescents, as mild curvatures that tend to progress and worsen through puberty. According to Hong Kong-based school screening studies, adolescent idiopathic scoliosis occurred between 2% to 13.6% of the population. The gender statistics showed an equal ratio between males and females for mild curves between 6 and 10 degrees. However, in moderate to severe cases where the curvatures were between 20 and 40 degrees, females proved to surpass males substantially. (Tang et al. 2003.)

What to look for:

If you think you, your partner or your child has scoliosis, you can look for the following common signs:

  • When viewing from behind a curve of the spine to the left or right.
  • One hip higher than the other.
  • One shoulder higher than the other.
  • A twist or rotation in the spine. You may notice this by the position of the arms – one may be resting further forward than the other when standing.

These observations aren’t conclusive that you have scoliosis, but may indicate some imbalances that can be investigated further by an osteopath or physical therapist.

Outcomes of Scoliosis

For most, scoliosis causes no pain and is not considered a serious health issue. Treatment for scoliosis varies depending on the case. With very mild cases, the condition can simply be monitored to ensure there is no further progression of the curve. For moderate to severe cases, there are various ways to manage scoliosis which have proved successful in the intervention, prevention, and correction of the deformity. These methods will be discussed in-depth in the article to follow.

REFERENCES:

  • Mayo Clinic. 2019. Scoliosis – Symptoms and causes. (online) Available at: https://www.mayoclinic.org/diseases-conditions/scoliosis/symptoms-causes/syc-20350716
  • Mei-chun Cheung & Joanne Yip & Lai-hing Fok & Garcia Kwok, 2017. Health-related quality of life in adolescents with mild scoliosis. International Institute of Social and Economic Sciences.
  • Tang, S., Cheng, J., Ng, B. and Lam, T., 2003. Adolescent Idiopathic Scoliosis (AIS): An Overview of the Etiology and Basic Management Principles. HK J Paediatr (new series), pp.299-306.