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Scoliosis is an abnormal sideways curve of the spine.

The cause is usually unknown

In profile, the healthy spine has three natural curves that form a loose ‘S’ shape: at the neck, upper back and lower back. From the rear, the healthy spine should look straight.

When a person has scoliosis, they have an abnormal sideways curve that makes the spine look tilted when viewed from the rear.

Scoliosis tends to develop in late childhood

About one in every two people is thought to have mild scoliosis, which is painless, does not worsen and does not need treatment.

However, severe scoliosis is a painful and debilitating condition that tends to worsen with age. About three children out of every 1000 have scoliosis that needs medical treatment.

Scoliosis can be mild, moderate or severe. The symptoms and signs of scoliosis can include: The curve is more pronounced when the child bends forward. Some of the different types of scoliosis include: – this is the most common type of scoliosis, accounting for about eight cases out of every 10.

Boys are more commonly affected

Girls are more commonly affected

Girls are more commonly affected

– scoliosis is uncommon in adults. Adult scoliosis is sometimes caused by a degenerative joint problem. In most cases, the scoliosis started in childhood but was not diagnosed until later in life. About two cases of scoliosis in every 10 have a known cause, including: – having one leg shorter than the other causes the hips to tilt.

To compensate, the shoulders tend to tilt the other way. This is known as ‘compensatory scoliosis’. – such as cerebral palsy. Muscle spasms can pull the vertebrae out of alignment. – such as osteoarthritis.

Current theories about the possible causes of idiopathic scoliosis include: – in some cases scoliosis appears to run in families.The precise genetic abnormality is currently unknown but is being investigated. – some children may be born with defects in certain structures including the brain stem and spinal cord.

These defects may play a role in the development of scoliosis in some cases.

– including problems with connective tissue (such as ligaments) or the nervous system. – some researchers theorise that hormones may contribute to scoliosis because the condition is more common in children who are approaching adolescence.

Most cases of scoliosis are mild and do not need medical treatment

However, progressive scoliosis is a curve that worsens as the years go by. Without medical treatment, progressive scoliosis can cause: Increased risk of osteoporosis in later life. Risk factors may include: – girls are more commonly affected than boys.

– generally speaking, scoliosis found in young children will resolve as they get older. If, however, the curve is progressive, it is likely a severe deformity will develop. Babies born with infantile idiopathic scoliosis tend to be at increased risk.

– severe angles are more likely to worsen than mild angles. Any abnormal curve in a child’s spine should be investigated, regardless of whether or not the child feels any pain.

Scoliosis is almost always painless at first

A child should also be screened if there is a family history of the condition.

Scoliosis is diagnosed by using x-rays and careful physical examination

Factors that are assessed during the examination include: The angle of the curve.

In severe cases, treatment may include: – the brace is an option for children prior to adolescence.

However, the brace does not guarantee a cure

In some cases, the spine may grow straight during adolescence. In other cases, the brace can only prevent the curve from worsening, or delay the need for surgery. – severe cases need surgical correction.

Various operations are available

An operation called ‘posterior spinal fusion and instrumentation’ may be recommended. This involves chocking the affected vertebrae with bone usually harvested from the patient’s pelvis. Surgically implanted rods, hooks, screws, wires or other devices keep the spine straight while the transplanted bone knits with the vertebrae.

The implants are usually permanent

Orthopaedic surgeon

Scoliosis is an abnormal sideways curve of the spine.

Symptoms One shoulder tilted down towards a raised hip, as if the child is leaning sideways Prominent ribs A protruding shoulder blade Tilted waist Different types of scoliosis Idiopathic (cause unknown) scoliosis Infantile idiopathic scoliosis Juvenile idiopathic scoliosis Adolescent idiopathic scoliosis Adult scoliosis Known causes Uneven leg length Neuromuscular conditions Certain diseases Current theories about idiopathic scoliosis Genetic factors Congenital abnormalities Other abnormalities Hormone problems Progressive scoliosis Constant back pain Inflammation of the back bones (vertebrae) Breathing difficulties as the ribcage is compressed Injury to the heart and lungs caused by deformities of the ribcage Susceptibility to chest infections such as pneumonia Problems with pregnancy because of the increased load on the already compromised spine Increased risk of bone loss Physical disability that may prevent working and impair quality of life Risk factors for progressive scoliosis Gender Age of onset Severity of the curve’s angle Diagnosis methods The shape of the curve (for example, an ‘S’ or ‘C’ shape) The location of the curve (in the upper back, lower back or both) Whether the curve leans towards the left or right side Treatment options Orthopaedic brace Surgery Where to get help Your doctor Things to remember.

Key Points

  • cause is usually unknown
  • About three children out of every 1000 have scoliosis that needs medical treatment
  • symptoms and signs of scoliosis can include: The curve is more pronounced when the child bends forward
  • Boys are more commonly affected
  • Girls are more commonly affected