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Scoliosis
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Scoliosis is a curvature of the spine such that the spine is curved sideways. Many people experience scoliosis when they have a growth spurt and this often heals itself. Other causes of scoliosis, such as cerebral palsy or perhaps muscular dystrophy, are not so easily treated and need intervention to correct.
Many cases of scoliosis are not severe; however, if you have severe scoliosis, it can be a debilitating disease. Severe curvature can impact the way the lung breathes, leading to breathing problems and shortness of breath.
The signs and symptoms of scoliosis include having uneven shoulders from spinal curvature, having an uneven waist line, having one hip higher than the other and having a shoulder blade more obvious than the other.
Curvature of the spine can get worse so that the spine can twist along with its lateral curvature. This impacts the way the ribs look, which can be more prominent on one side than on the other. Back pain is a common symptom of scoliosis which has become severe.
The most common types of scoliosis have no known cause. Much of the most common types of scoliosis appear to be hereditary but doctors don't have particular blood tests that can show who will get scoliosis and who will not. Such testing is, however, in the works.
The less common varieties of scoliosis can be caused by muscular dystrophy, a neuromuscular disease, birth defects that affect the spine and vertebrae, having one leg longer than the other and having wear and tear on the spine from osteoarthritis of the spine.
Risk factors for idiopathic scoliosis include being in a growth spurt. This means you are a female between the ages of 10-15 or a male between the ages of 12-18. More women or girls have a higher risk of developing scoliosis than males. Scoliosis also tends to be genetic in nature so it runs in families.
Tests for scoliosis include regular back x-rays that can show the degree of back curvature. This can be measured on the x-ray and followed over time. The underlying condition, such as a tumor causing curvature of the spine, may or may not need to be seen on x-ray. Magnetic resonance imagery uses strong magnetic field and radio waves to show the soft tissue images of the spinal area. A CT scan of the spine can also show external things that can influence the degree of scoliosis.
A bone scan involves the injection of a dye that is radioactive and that moves to injured or stressed areas of the bone. It is a good test to see how the spine is reacting to the scoliosis and whether or not there is a bony tumor that can influence the development of scoliosis.
Children who have mild scoliosis often don't need any treatment at all and are watched to see if they resolve their condition on their own. Some will need surgery or will need a brace to correct their problem. Regular checkups are necessary to see if the braces or surgery are working and to make sure the scoliosis isn't progressive.
Decisions to keep in mind when deciding to treat scoliosis include the gender of the individual. Girls tend to progress much more likely than males. Severe curvature of the spine needs to be treated more aggressively. Double curves usually progress more regularly and faster than do C-shaped scoliosis curves. If the curve is in the thorax, it is more likely to progress than curvatures in other areas of the spine. If the child has stopped his or her growth spurt, there is much less likelihood of progression. If, on the other hand, the scoliosis is occurring early in the growth spurt, it is more likely to progress.
The first obvious treatment is a back brace. This tends not to correct scoliosis but it prevents it from getting worse. Braces are worn twenty four hours a day and can be worn for many months. It is removed two years after the girl begins to menstruate or when boys must shave daily. There is an underarm brace that is made of plastic that conforms to the body. It extends under the close to the lumbar spine but allows for bending at the waist to sit down. A Milwaukee brace has a ring around the head and rests for the chin and for the back of the head. It has a bar in the front and two bars in the back. They are only used in severe cases.
Surgery is used for progressive scoliosis that is unresponsive to braces. It involves fusion of the vertebrae so that it cannot progressively curve. It can use hooks, metal rods, screws or wires to hold the spine in place in a straight position. Complications of surgery include infection, back pain, bleeding and nerve damage. The bone may not heal correctly, leading to an additional surgery.