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Scoliosis is a spine curvature that occurs most frequently in teens. While scoliosis can occur in persons with diseases such as cerebral palsy and muscular dystrophy, the majority of infantile scoliosis has no known cause.
The majority of scoliosis occurrences are moderate, although some curvature increase as children grow. Severe scoliosis can be incapacitating. A particularly severe spinal curve might restrict the amount of space within the chest, making optimal lung function difficult.
Children with moderate scoliosis are regularly watched, generally with X-rays, to see if the curve is worsening. Many times, no therapy is required. Some youngsters will require the use of a brace to prevent the curve from worsening. Others may require surgery to correct extreme curvature.
WHAT ARE THE SYMPTOMS OF SCOLIOSIS?
Scoliosis symptoms and signs may include:
- Shoulders that are uneven
- One shoulder blade that is more noticeable than the other
- Uneven waist
- One hip is higher than the other.
- One side of the rib cage protrudes.
- When leaning forward, there is a prominence on one side of the back.
In most cases of scoliosis, the spine rotates or twists in addition to curving side to side. As a result, the ribs or muscles on one side of the body protrude further than those on the other.
WHAT ARE THE CAUSES OF SCOLIOSIS?
Doctors aren't sure what causes the most prevalent type of scoliosis, although it appears to entail inherited elements because the illness can run in families. Less common causes of scoliosis include:
- Certain neuromuscular diseases, such as cerebral palsy or muscular dystrophy
- Birth abnormalities impacting the development of the spine's bones
- As a baby, you had surgery on your chest wall.
- Spinal cord injuries or infections
- Anomalies of the spinal cord
WHAT ARE THE RISK FACTORS FOR SCOLIOSIS?
The following are risk factors for acquiring the most prevalent type of scoliosis:
- Age: Adolescence is when signs and symptoms usually appear.
- Sex: Although both boys and girls develop mild scoliosis at roughly the same rate, girls are significantly more likely to have the curve worsen and require treatment.
- Family history: Scoliosis can run in families, although most youngsters with the illness have no family history.
WHAT ARE THE COMPLICATIONS OF SCOLIOSIS?
While most persons with scoliosis have a minor form of the illness, it can occasionally produce consequences such as:
- Breathing difficulties: In severe scoliosis, the rib cage may press against the lungs, making breathing difficult.
- Back issues: People who experienced scoliosis as children are more prone to develop persistent back pain as adults, particularly if their aberrant curves are significant and untreated.
- Appearance: As scoliosis progresses, more visible alterations might occur, such as unequal hips and shoulders, protruding ribs, and a shift of the waist and trunk to the side. Individuals suffering from scoliosis are frequently self-conscious about their appearance.
HOW IS SCOLIOSIS DIAGNOSED?
The doctor will first conduct a thorough medical history and may inquire about recent growth. During the physical exam, your doctor may ask your kid to stand and then lean forward from the waist, arms loosely hanging, to determine if one side of the rib cage is more pronounced than the other.
A neurological exam may also be performed by your doctor to check for:
- Muscle fatigue
- Numbness
- Abnormal reflexes
Imaging tests
Plain X-rays can confirm a scoliosis diagnosis and show the severity of the spinal curvature. Because several X-rays will be taken over the years to assess if the curve is worsening, repeated radiation exposure can become a worry.
To lessen this danger, your doctor may recommend a sort of imaging technology that creates a 3D model of the spine using lower amounts of radiation. This method, however, is not available at all medical centers. Another method is ultrasound, which is less exact in detecting the severity of the scoliosis curve.
If your doctor feels that an underlying disease, such as a spinal cord anomaly, is causing the scoliosis, MRI may be prescribed.
WHAT ARE THE TREATMENTS FOR SCOLIOSIS?
Treatment for scoliosis varies according to the severity of the curve. Children with extremely minor curves normally do not require any treatment, however they may require regular examinations to see if the curve worsens as they develop.
If the spinal curve is moderate or severe, bracing or surgery may be required. Consider the following factors:
- Maturity: The likelihood of curve progression is low if a child's bones have stopped developing. Braces are also more effective in youngsters whose bones are still growing. Hand X-rays can be used to assess bone maturity.
- Curve severity: Larger curves are more prone to deteriorate over time.
- Sex: Girls are far more likely than boys to progress.
Braces
Your doctor may recommend a brace if your child's bones are still growing and he or she has moderate scoliosis. Wearing a brace will not cure or reverse scoliosis, but it will usually keep the curve from worsening.
The most often used brace is constructed of plastic and shaped to fit the body. Because it fits under the arms and around the rib cage, lower back, and hips, this brace is nearly undetectable when worn.
The majority of braces are worn between 13 and 16 hours per day. The effectiveness of a brace rises with the amount of hours it is worn every day. Children who wear braces are usually able to participate in most activities with few limitations. Children can remove the brace to participate in sports or other physical activities if necessary.
When there are no more height fluctuations, braces are removed. Girls finish their growth at 14, and boys at 16, on average, but this varies substantially by person.
Surgery
Severe scoliosis usually worsens over time, therefore your doctor may recommend scoliosis surgery to help correct the curvature and keep it from worsening.
Among the surgical options are:
- Spinal fusion: During this operation, surgeons join two or more vertebrae in the spine so they can't move independently. Between the vertebrae, bone or bone-like material is inserted. Metal rods, hooks, screws, or wires are commonly used to keep that region of the spine straight and motionless while the old and new bone material fuses.
- Expanding rod: Surgeons can place one or two expandable rods along the spine that can adjust in length as the kid grows if the scoliosis is growing rapidly at a young age. Every 3 to 6 months, the rods are extended either surgically or in the clinic using a remote control.
- Vertebral body tethering: Small incisions can be used for this treatment. Screws are threaded through the screws along the outside edge of the aberrant spinal curve. The spine straightens as the cord is tightened. The spine may straighten even more as the youngster develops.
Spinal surgery complications might include bleeding, infection, or nerve injury.