Some 2400 years ago famous doctor Hippocrates was writing about abnormal curvature of the spine. He derived the name for that disorder from the Greek word for curvature and named it scoliosis.
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Our spine has a hard task: it must provide strength and support for the whole body. It must carry heavy bones of the skull, it provides stability, the lower part of the spine is carrying most of the body weight, and it allows movements of the torso. The spine is a very complex organ connected with the muscles, ligaments and tendons. Those structures allow our body to bend, stretch and rotate.
Our spine also protects the nerves and the spinal cord through which nerve impulses travel and control the functions of our major organs: without spinal cord our body can't function. Our spine has discs between each vertebrae which contain a substance that absorbs strong impacts and that system works like a shock absorber. The spine develops as we grow so newborn babies have almost straight spines, and when it begin to hold the weight of their head then the spine develops the characteristic curves.
Scoliosis is a curvature of the spine which shouldn't be there. Every problem in spine reflects on the whole body and the scoliosis is not the exception. The health problems and consequences of scoliosis are well known and there are many causes of that disorder. What we do know is that there is a genetic link: around 25% of those with a scoliosis have a direct relative with a scoliosis. It's also interesting that 80% of adolescence idiopathic scoliosis we find in girls, and 80% of those girls have their rib deformed on the right side.
There are two main types of scoliosis: idiopathic (with no known cause) and syndromic (the curvature is a part of a known disease). Idiopathic scoliosis is the most frequent scoliosis and it may appear in early childhood, in adolescence or anywhere inbetween.
The spine can bend towards left or right side of the body at any place, from top to bottom. If it bends in the chest area that's thoracic scoliosis, and if the problem is in the lower part of the back, that's lumbar scoliosis. If the spine bends above and below these areas, that's thoracolumbar scoliosis. But that's not all: the spine can bend twice making an S-shaped curve.
Scoliosis is a very common disorder: 75 percent of children need doctor's help and about one child in thousand will need hospital treatment, usually a major corrective surgery. If scoliosis develops in infancy there is a good chance it will be gone as the person grows. Progressive early scoliosis is serious and in some cases the child may need surgical treatment. Late scoliosis is less serious although in some cases the surgery is needed.
Scoliosis can be diagnosed very easily: one shoulder is tilted down towards a raised hip, ribs are prominent, waist is tilted, and shoulder blade is protruding. If you look at the child and the curve is more visible when the child bends forward, that's scoliosis. It's also easily visible on X-rays as an S or C shape.
The severity of the curve is measured in degrees which help to determine the proper treatment.
Serious deformity, which is not common today because of modern treatment, can lead to damaged lung function or disability in middle age. The lungs are usually affected only in people with untreated early thoracic scoliosis when the chest part of the spine is curved.
The treatment for scoliosis usually depends on the severity of the curve. Some people live the whole life without knowing that they have the condition. If the patient has scoliosis with a spinal curve of 25 to 40 degrees and is still growing, the doctor may recommend wearing a brace to keep the curve in the spine from getting worse. If the patient is completed his growth (boys after 17, girls after 15), those curves are not likely to cause problems later in life.
Surgery for adolescents is recommended when their curves are greater than 40 to 45 degrees. The goal of the surgery is to reduce the patient's curvature and to prevent further progression of the deformity. If the curve is allowed to progress to 70 - 90 degrees, it will not only look badly but it will have serious life consequences. At those curvatures the spine rotates the chest and closes down the space available for the lungs and heart which means very serious problems with breathing and blood circulation.
While some doctors may recommend exercise there is little scientific evidence about the effectiveness of exercising. The point is that scoliosis is not caused by a deficiency of strength or flexibility, so exercise is ineffective in correcting scoliosis. ■
Scoliosis can be diagnosed very easily: one shoulder is tilted down towards a raised hip, ribs are prominent, waist is tilted, and shoulder blade is protruding. If you look at the child and the curve is more visible when the child bends forward, that's scoliosis. It's also easily visible on X-rays as an S or C shape.