When the Spine Curves: Treatments for Scoliosis

Present Knowledge of Scoliosis

What is Scoliosis?

Scoliosis is a curvature of the spine, usually appearing at the onset of puberty. As yet, it has no known cause. More specifically, scoliosis is a spinal abnormality in which the spine curves away from the "middle line" of the back, and the vertebrae in the curve rotate. The curvature can occur in either the upper (thoracic) or lower (lumbar) spine. A healthy spine curves naturally when viewed from the side, giving the shoulders a round appearance and making the lower back slope slightly inward. When x-rayed in this position, the spine appears as a straight line from the neck to the hips. The scoliotic spine often appears as a letter "S" or "C" on an x-ray, depending on the kind of curve present.

1. X-ray of a spine unaffected by scoliosis 1999 Courtesy of Stuart Weinstein, MD, UIHC Department of Orthopaedics

2.X-ray of scoliotic spine with a 100 degree curve 1937 Courtesy of Stuart Weinstein, MD, UIHC Department of Orthopaedics

Scoliosis usually develops during middle to late childhood, but becomes noticeable in adolescence. The peak ages for development and curve progression are 11-14 for girls and 13-16 for boys. Mild curves of 30 degrees or less are as likely in boys as they are in girls; however, progression to a severe curve of greater than 60 degrees is more common in girls. This progression usually occurs during the rapid growth period of adolescence. Despite this, most scoliotic curves remain mild and do not require treatment.

Idiopathic (having no known cause) scoliosis makes up 80 percent of the cases treated by physicians. Heredity has been linked to the development of scoliosis, however no specific genes have yet been identified as those that carry scoliosis. Thus, it is advised that children in families with scoliotic members be examined and observed by a physician. Occasionally, a child may be born with scoliosis or may develop it at a young age as a result of another disease. Cerebral palsy, polio and muscular dystrophy have been associated with the development of scoliosis. Scoliosis does not occur as a result of life-style or poor posture. Carrying heavy objects, participating in athletic activities, or the presence of a minor difference in leg lengths do not cause scoliosis. Likewise, attempting to correct poor posture by standing up straight will not cure scoliosis or reduce the severity of curvature.

Scoliosis affects a small part of the population, about two percent of women and less than a half percent of men. The condition can be found in most countries and in all races.