Scoliosis

The symptoms of scoliosis can vary depending on the severity of the curvature and the age of the individual. Common signs and symptoms include:

• Uneven shoulders or shoulder blades
• Asymmetrical waist or hips
• One shoulder blade protruding more than the other
• Rib prominence or a noticeable hump on one side when bending forward
• Back pain, particularly in adults
• Fatigue after prolonged sitting or standing
• In severe cases, scoliosis can lead to respiratory and cardiovascular issues due to the restricted space within the chest cavity.

There are 4 types:

1. Adolescent Idiopathic scoliosis is the most common type accounting for 80% of cases with no known specific cause. It is an abnormal curvature that appears in late childhood or adolescence during a growth spurt, typically between the ages of 10 and 18. It is estimated to affect 1-3% of children in their teen years with a preference for girls. 30% of cases have a family history of scoliosis. This type is generally mild.
2. Neuromuscular scoliosis is due to diseases of the nerves and muscles that causes trunk imbalance, and includes muscular dystrophy, cerebral palsy, Marfan’s syndrome, and multiple other conditions.
3. Congenital scoliosis is caused by abnormal development in the womb leading to vertebral malformations.  Congenital scoliosis may only become noticeable when the child goes through a growth spurt around age 2 and between 8 – 13 years of age.
4. Degenerative scoliosis is found after age 40, usually due to age-related changes such as degenerative disc disease, spinal arthritis and osteoporosis.

Dr. Colman will take a detailed medical history, ask about your child’s growth patterns, and conduct a physical exam which may also include testing for muscle weakness, numbness and abnormal reflexes. He will order X-rays to confirm the diagnosis and may order advanced imaging studies to assess the spinal cord, nerves, or underlying structural abnormalities.

Treatment options will depend on the degree of curvature, the curve pattern, the curve location, and the maturity of the child. Generally, treatment options include:

1. Observation: For mild curves (less than 20 degrees), especially in growing children, regular monitoring every 4-6 months may be sufficient to track progression.
2. Bracing: Used for moderate curves (20-40 degrees) in growing children and adolescents is used to prevent further progression. The type and duration of bracing depend on the location and severity of the curve.
3. Physical Therapy: Exercises and stretches are designed to improve posture, strengthen muscles, and maintain spinal flexibility. While physical therapy does not correct the curvature, it can help manage symptoms and improve overall function.
4. Surgery: Surgery may be recommended for severe curves (greater than 40-50 degrees) or cases where conservative treatments fail. The most common surgical procedure is spinal fusion, which involves correcting the curvature and fusing the affected vertebrae together using metal rods, screws, and bone grafts.

In addition to these treatments, pain management strategies, such as medications or spinal injections, may be used to alleviate discomfort, particularly in adults with degenerative scoliosis.

Scoliosis is a complex condition requiring a personalized approach to management. Early detection and appropriate intervention are crucial in preventing complications and improving the quality of life for affected individuals.