Scoliosis (Curved Spine): Symptoms, types, diagnosis and treatment

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Scoliosis (Curved Spine)
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Scoliosis (Curved Spine)

• Scoliosis is not a disease. It is a condition in
  which there is an abnormal sideways curvature in
  the spine. Any part of the spine can bend but the
  most common parts that get affected are the chest
  (upper back) area or the lower part of the back.
  The spine can curve to the right, left or
  sometimes both the sides. The curve can occur in
  varying degrees, which determines the severity of
  the condition. When the curve occurs in
  the lumbar (lower) region of the spine, it does
  not affect the posture. However, the curve in the
  thoracic (upper) region causes a twist in the rib
  cage, which makes the misalignment of the body
  more visible. If the curve gets worse, the spine
  may rotate or even twist. In an extreme case of
  scoliosis, there may be severe back pain and
  other vital organs like the lungs, heart may get
  damaged. 

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Scoliosis (Curved Spine)
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• When scoliosis occurs, the curves of the spine
  can be classified on the basis of their shape in
  the following ways 
• Levoscoliosis In this type the curvature of the
  spine is towards left giving it the "C" shape.
  This type of scoliosis is considered to be the
  most dangerous as the heart is located in that
  area and may be in danger. The degree of the
  curve determines the severity of the disorder.
• Dextroscoliosis In this type the curvature is to
  the opposite side of levoscoliosis i.e., towards
  the right and looks like a backward "C". The
  curve is also known as lordotic curve.
• Dextroscoliosis (forming an "S" shape) In this
  type of scoliosis, there are two curves in the
  spinal column, which result in an "S" shaped
  spine.

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Types of scoliosis

• Congenital ScoliosisIt occurs before birth
  while the foetus is growing in the womb. A part
  of one or more vertebrae, during the formation of
  the spine, may not form properly leading to a
  curved spine. Also, the spine initially forms as
  a single column of tissue and then separates into
  various bony segments called vertebrae. However,
  when the separation is incomplete, two or more
  vertebrae are fused together which stops the
  spinal growth from one side resulting into a
  spinal curve. It is a very rare condition.
  However, if it occurs then needs to be corrected
  surgically. Neuromuscular Scoliosis It is
  caused by poor muscle control or muscle weakness
  and illnesses that affect the nerves. A disorder
  called cerebral palsy may cause neuromuscular
  scoliosis. p

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Types of scoliosis
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• It is a condition wherein there is a brain
  damage that occurs at birth or a while later.
  Another illness that may result in neuromuscular
  scoliosis is muscular dystrophy, a genetic
  disorder that weakens the muscles. Certain other
  disorders that may cause neuromuscular scoliosis
  are spina bifida and polio. Idiopathic
  Scoliosis When scoliosis develops in a
  previously straight spine without an identifiable
  cause, it is known as idiopathic scoliosis. It is
  the most common type of scoliosis usually
  observed in girls. It is more common in
  adolescents, and gets worse as they grow. The
  curve may become more pronounced in the later
  stages of life. 

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Types of scoliosis
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• Degenerative ScoliosisIt usually occurs in
  women above 40 years of age. Because of the
  deterioration of bones, the spine loses ability
  to maintain its normal shape and begins to sag.
  This results into a scoliotic curve in the spine.
  Degenerative scoliosis may also result from
  injuries or illnesses like a major back injury,
  osteoporosis or a traumatic bone collapse. The
  parts of the spine that are involved in the
  damage are vertebrae that support the spine and
  the neck, tendons that connect the bones in the
  spine to the muscles, discs that provide a
  cushion to the vertebrae and the ligaments that
  hold the discs and vertebrae together.

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Causes of scoliosis

• Doctors don't know what causes the most common
  type of scoliosis, although it appears to involve
  hereditary factors, because the disorder tends to
  run in families. Less common types of scoliosis
  may be caused by 
• Neuromuscular conditions, such as cerebral
  palsy or muscular dystrophy
• Birth defects affecting the development of the
  bones of the spine
• Injuries to or infections of the spine

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Symptoms

• The symptoms of scoliosis may differ from one
  individual to another depending upon the type,
  cause and severity of the disorder. However,
  there are some common symptoms, which include 
• The head tilted and not in line with rest of the
  body
• The hip appearing lower than the usual position
  and tilted to one side
• One shoulder blade appearing higher than the
  other
• Shoulders uneven in height
• An uneven neckline
• The breasts developing in unequal size, in young
  girls
• On bending forward, one side of the upper back
  appearing higher than the other

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Symptoms
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• A person with scoliosis is likely to experience
  backache or lower-back pain. After a long period
  of sitting or standing, they are also likely to
  feel weakness in the spine. The pain usually gets
  worse, if irritation results. Severe scoliosis,
  where the curve in the spine is greater than 100
  degrees, can cause breathing problems.

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Diagnosis of scoliosis

• In order to diagnose scoliosis, a doctor will
  first carry out a physical examination. Part of
  it is a forward bending test that will enable the
  doctor to define the curve. However, this is not
  sufficient for the degree of the curve to be
  clearly defined, so an x-ray, taken from the
  front and side of the spine is usually
  recommended. The doctor will also perform
  a neurological exam to look for any changes in
  strength, sensation, or reflexes. Additionally,
  scoliometer measurements (a device for measuring
  the curvature of the spine) are usually taken,
  and if required, an MRI scan may be carried out.

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Treatments

• In mild cases of scoliosis a treatment is not
  required. Repeated examinations every 4 to 6
  months are done to determine the progress of the
  curve. If the curve continues to grow, the doctor
  may recommend either of the following treatment
  options
• Bracing If idiopathic scoliosis is more than 25
  to 30 degrees, in a growing child, a brace is
  recommended to slow the progression of the
  curve. Braces are of several types and each of
  them appears and functions differently. A brace
  does the act of putting pressure on the spine to
  straighten it and is adjusted as the person
  grows. However, it cannot be utilized for cases
  of congenital or neuromuscular scoliosis.

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Treatments
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• Surgery A surgical treatment for scoliosis is
  recommended only when the spinal curve is above
  50 degrees and the bracing technique fails to
  correct the problem. If the curve is between 40
  to 50 degrees the doctors have to consider all
  the surrounding factors before recommending a
  surgery. The main objective behind a surgery is
  to correct the spinal curve and prevent it from
  getting worse. However, the result would not be a
  perfectly straight spine but will definitely
  prevent it from worsening.

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