What is Scoliosis?
Scoliosis is lateral (sideways) curving of the spine. The degree of Scoliosis may range from mild to severe. The sideways curve of the Scoliosis spine is 10 degrees or higher. Scoliosis occurs most often in children age 10 to 14, affecting females 7 times more frequently than males.
How Scoliosis looks
Scoliosis patients lose some of the curves in their neck, resulting in forwarding head posture. Because of the sideway curve, the rib cage twist and normal curve of the spine have flattened. A Scoliosis curve looks flat where the spine is normally curved when viewed from the front or side. It appears twisted where there is typically no twist when viewed from top-down. It may or may not tilt the pelvis.
Types of Scoliosis
Structural Scoliosis
It involves spinal rotation in addition to the side to side curvature of the spine. This type of scoliosis affects the spine's structure and is considered permanent unless the spine receives treatment.
Types of structural Scoliosis
Idiopathic Scoliosis
The most common type of scoliosis. Depending on the age of onset, it may be infantile (birth to 3 years), juvenile (age 3 to 8), adolescent (age 9 to 18) or adult scoliosis (after 18 years). Adolescent idiopathic scoliosis is the most common type of scoliosis and is usually diagnosed during puberty.
Congenital Scoliosis
A rare form of scoliosis, resulting from embryological malformation of one or more vertebrae. The vertebral abnormalities cause curvature and other deformities of the spine because one area of the spinal column lengthens at a slower rate than the rest.
Neuromuscular or syndromic Scoliosis
Developed by children who have neuromuscular disorders like muscular dystrophy or cerebral palsy. This type of scoliosis generally progresses more rapidly than idiopathic scoliosis and often requires surgical treatment.
Degenerative Scoliosis
Adult scoliosis; a degenerative condition that typically occurs after age 40.
Nonstructural Scoliosis
Also known as functional scoliosis, results from a temporary cause and only involves a side to side curvature of the spine(no spinal rotation). The spine structure is still normal.
Common causes of nonstructural Scoliosis
Muscle spasms
If the major muscle in the back start to spasm, the spine could be pulled in one direction and a sideways curve may result.
The difference in leg heights
When one leg is significantly longer than the other, scoliosis curves may be present while standing.
Inflammation
If an area of the body to one side of the spine or the other starts to become inflamed, a scoliosis curve can result. Some possible causes could be appendicitis or pneumonia.
According to the affected area of the spine, scoliosis can also be classified as lumbar scoliosis, thoracic scoliosis, thoracic-lumber scoliosis and combined scoliosis.
How to measure the Scoliosis?
The cobb method is used to measure the degree of Scoliosis. In this case, choose the most tilted vertebra above and below the apex of the curve. The angle between intersecting lines drawn perpendicular to the top of the top vertebrae and bottom of the bottom vertebrae is the cobb angle.
What are the risk factors of Scoliosis?
Age
Symptoms tend to start during a child’s growth spurt which occurs just before puberty (typically between the ages of nine and 15).
Gender
Girls tend to have a higher risk of scoliosis. While both girls and boys tend to develop mild cases of scoliosis at roughly the same rate, girls will usually have a greater risk of spinal curvature progressing and require more aggressive treatment.
Family history
Scoliosis appears to run in some families and having a family history with direct relatives affected by the condition increase one’s chances of developing it.
What are the Complications of Scoliosis?
Heart and lung damage
When scoliosis is severe, then the rib cage may press against the heart and lungs. This makes it difficult to breathe and for the heart to pump, thus damaging the lungs and heart.
Back issues
If one has scoliosis as a child, the chances of suffering from chronic back pain later in life are higher.
Appearance
When scoliosis progresses, it may result in visible changes to the body. For example, the shoulders or hips may appear uneven, ribs may be prominent or a shift in the trunk and waist to one side may be evident. This often results in the sufferer feeling self-conscious about their appearance.
The signs of Scoliosis.
Head not centred over the body.
The eye line tilted.
Shoulders are uneven.
One-shoulder blade higher and possibly more prominent.
One hip higher than others.
Prominent ribs.
Hand hanging at different lengths when standing.
Sideways curvature of the spine.
Sideways body posture.
One shoulder raised higher than the other.
Clothes not hanging properly.
Local muscular aches.
Local ligament pain.
Decreasing pulmonary function, major concern in progressive severe scoliosis.
Physiotherapy management helps slow down the development of muscle imbalance and joint stiffness by strengthening the weak muscles and improving flexibility of the tight tissues. So it helps to reduce the symptoms of scoliosis and to avoid going into surgery.
Yashodha Masinghe
References
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