The normal spine, when viewed from the side has natural curves that round our shoulders, and make our lower back curve slightly inward. However, some people develop a sideways curvature of the spine, and this condition is called scoliosis.

People of all ages can develop scoliosis, but it most often occurs in children, usually after the age of 10, and is more common in girls than in boys. Approximately 3 to 5 of every 1000 children will develop spinal curves large enough to require treatment. The most common form of scoliosis is called Adolescent Idiopathic Scoliosis (scoliosis of unknown cause), which accounts for 80 – 85% of all cases.

Scoliosis can run in families, so a child who has a parent, brother, or sister with idiopathic scoliosis should be checked regularly.

Adults can also develop scoliosis. Usually, adult scoliosis is a result of a progression of condition that began in childhood, but was not detected or treated while the person was still growing. In other cases, scoliosis can develop as a result of degenerative disc disease and osteoporosis.

Diagnosis
Idiopathic scoliosis can go undetected in children for years because it is rarely painful in its initial stages. This makes it very important that parents and family physicians watch for the following early manifestations of scoliosis, beginning at around age eight:

• Uneven shoulders
• One hip higher than the other
• Leaning to one side
• Uneven waist
• Prominent shoulder blades or shoulder blade

The appearance of any one of these signs indicates the need for an evaluation by a physician.

The doctor will then take a medical history, and perform a physical examination. During the exam, the doctor will check if the shoulders are level, and with the patient leaning forward, see if one side of the rib cage is higher than the other.

If a significant spinal curve is detected, an x-ray is helpful to determine its severity, the x-ray will be taken with the patient standing with the back towards the x-ray machine. The doctor will then measure the curve to determine how to best treat the scoliosis.

Treatment
In the majority of cases, the curves detected are very mild, and will not require treatment. Generally, curves greater than 20 degrees require treatment. The recommended treatment will depend on a number of factors including the patient’s age, how much more he or she is likely to grow, the degree and pattern of the curve, and the type of scoliosis. Treatments include observation, bracing, and surgery.

• Observation may be all that is necessary. The doctor will examine the patient every 4-6 months while he or she is still growing.
• Bracing may be recommended to stop a curve from getting worse.
• Surgery may be recommended for severe cases to correct a curve or stop it from worsening while the patient is still growing.
  

What else can be done?

People have tried other ways to treat scoliosis, however, at this time, the following treatments have not been shown to prevent scoliosis from worsening:

• Chiropractic manipulation
• Electrical stimulation
• Nutritional supplements
• Exercise (It is important to note that exercise is encouraged for patients with scoliosis, as it is important for general health and well-being)

In Summary
Scoliosis is a problem that usually requires only observation with regular examinations during the growing years. Key to managing scoliosis is early detection, so that the curve does not get a chance to progress. For the small number of patients that will require medical treatment, the advances in modern orthopedic techniques have made scoliosis a very manageable condition. Your orthopedic specialist has experience and training in the diseases of the muscles and bones, and can diagnose, treat, and monitor this condition.