Scoliosis is a condition that causes a curve in the spine. The spine, when viewed from the side should have a gentle curve; however, when viewed from the back, it should appear straight. When scoliosis develops, the spine will appear, not straight, but curved to one side, forming a C or S shape.
Scoliosis is idiopathic, meaning the cause of the illness is not known. The incidence of scoliosis is greater in the female population, occurring in approximately 2 percent of females and 0.5 percent of males. The age of onset drives the naming of a particular type of scoliosis; if onset is before age three, which is extremely rare, the condition is called infantile idiopathic scoliosis. What is known as juvenile idiopathic scoliosis describes scoliosis diagnosed between the age of 3 and 10, and adolescent idiopathic scoliosis describes onset after age 10.
The major symptom of scoliosis is an unnatural curvature of the spine and may be noticed by a family member; however, the change is so gradual it may be hard to see until it the curve is more pronounced. Scoliosis is one of the medical conditions routinely screened for in school and is many times diagnosed during that screening. Other indications of scoliosis can be a misalignment of the head, hips, shoulders and/or rib cage.
If the situation warrants, seek the advice of a doctor who will examine the spine by visually assessing what can be seen by the naked eye in a number of tests such as bending to touch the toes which can exaggerate the curve and/or show asymmetry in the hips or shoulders. The doctor may also test range of motion and strength. The younger the patient, the more chance of further distortion as the child grows. The older the child, the less growing he will have left and the less the spine will continue to curve. The sooner scoliosis is diagnosed, the sooner it can be treated. It does not generally cause pain, but in severe cases, the twisting of the spine can make breathing difficult, and cause the heart and lungs to work harder.
For those patients believed to have scoliosis, X-rays of the back may be taken to compare to future X-rays to determine the rate of advancement. In some cases, the doctor will request a follow-up visit to assess any changes. In addition, X-rays of the hand, wrist, and/or pelvis may be taken to estimate the amount of growth to come before the patient is full-grown. If potential nerve damage is detected, an MRI or CT scan may be ordered to further assess the bones and nerves.
Treatment is based on the severity of the curve and the potential for further curving. In some cases, observation in the form of follow-up doctor’s visits will be ordered; other cases may require a brace or surgery.
After taking everything into account, bracing may be advised, not to reverse curvature, but to slow the process and prevent the curve from worsening. If the curve is less than 40 degrees when diagnosed, the doctor’s advice is followed, and the progression of the curve is prevented until growth is complete, a brace can be the only treatment needed.
When in doubt with any medical condition, it is best to err on the side of caution and see your child’s doctor as soon as possible.