Scoliosis

What is Scoliosis

Scoliosis is a condition characterised by a sideways curvature of the spine. This curvature typically develops during the growth spurt just before puberty.

Scoliosis is diagnosed when the curvature of the spine exceeds 10 degrees on the Cobb measurement, which is determined using a standing radiograph. The condition can be caused by various factors, including cerebral palsy and muscular dystrophy. In most instances, the exact cause of scoliosis remains unidentified​​.

Symptoms

Scoliosis manifests through several physical signs, each varying in severity depending on the individual case.

• One Shoulder Blade Being More Prominent: This asymmetry is a common indication, where one shoulder blade appears more noticeable than the other.
• Uneven Shoulders: Individuals with scoliosis often exhibit shoulders that are not level.
• Uneven Waist: This is characterised by one side of the waist appearing higher or more pronounced than the other.
• One Hip Being Higher: Similar to uneven shoulders, one hip may be higher or more prominent than the other.
• Spinal Rotation: In advanced cases, the spine not only curves but also rotates or twists. This can result in the ribs on one side of the body protruding more than on the other side.
• Compression of Internal Organs: Severe scoliosis may lead to the compression of internal organs, potentially impacting their function.
• Changes in Body Shape: In extreme cases, scoliosis can lead to noticeable changes in body shape, including pronounced ribs and shifted waist and trunk​​.

Causes and Risk Factors

The cause of most scoliosis cases is not determined. These are typically referred to as idiopathic scoliosis. Less common types of scoliosis may be caused by certain associated conditions and the risk of developing scoliosis can be heightened by several risk factors.

• Associated Conditions
  In some instances, scoliosis is caused by conditions such as cerebral palsy and muscular dystrophy.
• Adolescents Just Before Puberty
  The onset of scoliosis symptoms usually occurs during the growth spurt just before puberty.
• Higher Incidence in Females
  While scoliosis affects both genders, girls are more likely to experience a worsening of the curve that may require treatment.
• Hereditary Aspect
  While not all children with scoliosis have a family history of it, studies suggest a hereditary aspect to developing the condition​​.

Non-Surgical Treatment Options

Non-surgical treatment approaches for scoliosis vary based on the severity and progression of the curve.

Monitoring the Spine

In cases of mild scoliosis in children, regular monitoring is often recommended to track any changes in the curvature as the child grows.

Bracing

For moderate scoliosis, especially when the patient’s bones are still growing, bracing is a common treatment. The most prevalent type of brace is made of plastic, contoured to fit the body.

Bracing aims to prevent the curve from worsening. It is most effective when worn as prescribed and is usually discontinued once bone growth has stopped​​​​.

Surgical Treatment Options

Surgery can be considered to reduce the severity of the spinal curve and prevent further progression. It should only be performed if non-surgical options have failed to provide relief or in severe cases​​​​.

• Spinal Fusion
  This is the most common surgical procedure for scoliosis. It involves connecting two or more vertebrae, using bone or bone-like material between them. Metal rods, hooks, screws, or wires are used to hold the spine straight during the fusion process.
• Expanding Rod
  Used in certain cases of scoliosis in young children, this involves attaching one or two expandable rods along the spine. These rods can be lengthened every few months, either surgically or in the clinic using remote control, to accommodate the child’s growth.
• Vertebral Body Tethering
  A less invasive option, this surgery involves placing screws along the spinal curve and a flexible cord through the screws. Tightening the cord straightens the spine and may allow further straightening as the child grows.

Prevention Strategies

While not all forms of scoliosis can be prevented, certain strategies can be employed to mitigate risk factors and monitor early signs.

• Nutrient Therapies and Exercise for Those at Risk: Specially designed nutrient therapies and exercise programs can help those at risk of developing scoliosis. This may include foods to promote bone health and exercises to strengthen the core.
• Maintaining a Good Posture: Maintaining a good posture can help lead to greater spinal health. This can be beneficial, especially for degenerative scoliosis, which is often related to spinal health over time.
• Engaging in Regular Screenings: Regular screenings should be conducted in adults, particularly those over 40 with a history of spinal curvature.
• Avoiding Activities that Can Trigger Scoliosis: Understanding and avoiding activities that may trigger the progression of scoliosis can help manage the condition. Triggers may include carrying heavy loads unevenly or engaging in certain repetitive movements.