Scoliosis

Imagine your spine as a tower of building blocks, each vertebra stacked neatly atop the
other. There’s a slight curve from back to front in the lower spine. But when viewed from
the back, a normal spine forms a straight line from top to bottom.

When you have scoliosis, this orderly arrangement gets disrupted. Your spine curves
abnormally, resembling the shape of the letters S or C when viewed from the back.

This side-to-side curvature of the spine is the most telling sign of scoliosis. Abnormal curves
may turn to the left or the right and they may appear in the top, middle or bottom sections
of your spine.

What is scoliosis?

While a slight sideways curvature in the spine may be normal, individuals with scoliosis
experience a pronounced curve.

Scoliosis typically presents itself during childhood or adolescence, though it can also
develop in adults and is known to be hereditary. The exact cause remains unknown in over
two-thirds of cases. However, in the remaining third, scoliosis can be attributed to factors
such as degenerative disc disease or neuromuscular conditions.

Types & classifications of scoliosis

Scoliosis presents itself in different ways. Your doctor will classify the type of scoliosis in one of four categories based on the location and direction of the curve in the spine:

• Thoratec scoliosis: The curve is noticeable in the thoracic (middle) section of your
  spine.
• Lumbar scoliosis: The curve is noticeable in the lower section of the spine (lumbar
  spine).
• Thoracolumbar scoliosis: The curvature is noticeable where the thoracic and lumbar
  sections of the spine meet.
• Double curve scoliosis: There are two visible curves in the spine.

Furthermore, scoliosis manifests in four types, each distinguished by when it develops and its underlying cause. Since each is different, treatment for scoliosis is often tailored to each individual.

The types of scoliosis include:

• Congenital scoliosis: Present at birth, congenital scoliosis stems from abnormalities in vertebrae formation during a baby’s development.
• Degenerative scoliosis: This type emerges in adulthood as a complication of conditions such as arthritis or osteoporosis, causing curvature as the spine undergoes degenerative changes over time.
• Idiopathic scoliosis: The most prevalent form, idiopathic scoliosis typically arises during adolescence. The term "idiopathic" denotes that its cause remains unknown. While it can affect otherwise healthy individuals, its progression often coincides with growth spurts.
• Neuromuscular scoliosis: Linked to conditions affecting muscles or nerves, such as cerebral palsy, muscular dystrophy or spinal cord injuries, neuromuscular scoliosis arises due to compromised spinal support from affected muscles.

Can I live normally with scoliosis?

The impact of scoliosis on daily life varies widely, due to factors like the severity of the curvature, associated symptoms and the effectiveness of treatment.

For individuals with mild scoliosis, symptoms may be absent, and daily activities, sports and hobbies can be pursued without major impediments. In such cases, regular monitoring by your provider may be the only requirement.

In more severe instances, discomfort, pain, or limitations in certain activities may arise. Treatment options like bracing, physical therapy or surgery might be advised to alleviate symptoms, halt progression and enhance quality of life.

Scoliosis symptoms

Symptoms of scoliosis can manifest differently for everyone, contingent upon the severity and progression of spinal curvature.

Common symptoms include:

• Back pain
• Difficulty breathing
• Fatigue
• Noticeable spinal curve
• Shoulder asymmetry
• Tilting to one side
• Uneven hips
• Uneven rib cage
• Variation in leg length

Notably, scoliosis can exist without causing symptoms, particularly in mild cases. Routine check-ups with your provider, especially during adolescence when scoliosis commonly develops, are crucial for detection and ongoing monitoring of the condition.

 

Diagnosing scoliosis

Diagnosing scoliosis entails a comprehensive approach involving a physical exam, medical
history review and imaging tests.

During the physical exam, your doctor evaluates posture, spinal alignment, shoulder and
waist symmetry, and any noticeable abnormalities. Gait and mobility are also assessed.

Your doctor will inquire about any scoliosis symptoms, family history of spinal conditions,
and potential risk factors or underlying medical conditions contributing to scoliosis.

To confirm diagnosis and assess the severity and characteristics of the spinal curve, imaging
tests such as X-rays are typically conducted. In some cases, additional tests like MRI or a CT
scan may be ordered to dive deeper or identify underlying causes or complications
associated with scoliosis.

Upon confirmation of scoliosis diagnosis, your provider will team with other Advocate
specialists to determine the right treatment plan for you.

Scoliosis treatment

At Advocate Health Care, we prioritize your well-being by offering personalized treatment
plans designed by a team of specialists collaborating closely. Our integrated approach
combines the expertise of spine specialists, chiropractors and physical therapy
professionals, emphasizing noninvasive treatment options whenever possible.

Treatment for scoliosis varies depending on factors such as the severity of the curve in your
spine, your age and any associated symptoms or complications.

Observation

If scoliosis is mild and not progressing, your provider may recommend regular monitoring
without immediate intervention. This often involves periodic check-ups and X-rays to assess
the progression of the curvature.

Bracing

Bracing is commonly used in adolescents with moderate scoliosis to prevent further
curvature progression. This involves wearing a specialized brace for several hours daily to
support spinal alignment during growth.

Scoliosis therapies

Physical therapy can be beneficial for strengthening spinal muscles, enhancing flexibility
and maintaining proper posture. Physical therapy also aids in pain relief and overall
functional improvement.

Surgical options

In severe scoliosis where conservative treatments are ineffective, spinal fusion surgery may
be considered, particularly if scoliosis poses risks to heart or lung function. This procedure
involves permanently fusing vertebrae together using metal rods, screws and bone grafts.