A normal spine has several front-to-back curves between the neck and the pelvis. In scoliosis, the spine curves abnormally to the side or twists. Although scoliosis seems to run in some families, most cases appear for unknown reasons in children and adolescents who previously had a straight spine. Scoliosis without a known cause is called idiopathic scoliosis. Girls and boys are affected equally by idiopathic scoliosis, but girls with this condition are more likely to develop curves that get big enough to requirescoliosis treatment. In a few cases, the cause of scoliosis is known. These include:
Congenital scoliosis – This happens when the spine fails to form completely or forms improperly during development.
Neuromuscular scoliosis – This can happen when the spine's discs and bones break or deteriorate in adulthood. It also can happen because certain diseases, such as cerebral palsy, cause the muscles to support the spine unevenly or to pull at the spine unevenly.
Osteoporosis with fractures — The bones are prone to fracture in people with osteoporosis and the spine is a favored location for fracture. If one side of a vertebra compresses more than the other side after it fractures, the spine may curve as a result.
Treatments
The treatment plan for your scoliosis depends on its severity and may slightly vary by doctor. In general, however, treatment is prescribed as:
Observation. Recommended for curves less than 25º to 30º or people who have stopped growing and have curves that aren't changing or causing problems. Many kids have curves that will never progress past 25ºor 30º and will never need to wear a brace. X-ray evaluations occur every 4 to 6 months so doctors can determine whether bracing is necessary.
Bracing. Recommended for curves larger than 25º, but smaller than 45º to 50º in someone who is still growing.
Surgery. Recommended for people with curves usually greater than 45º or 50º and/or who are at high risk of continued worsening even after they are finished growing. Curves that grow very large may cause pain, limit certain body functions and cause difficulty or discomfort in breathing. Surgery is almost always a family decision, one that you and your family or guardians will make based on how you feel.
While yoga, physical therapy, or chiropractic medicine have not been scientifically proven to prevent curve progression, they can help strengthen your core and manage pain.
Starting at age 8 or 10, most children and adolescents are checked for scoliosis at each routine physical examination. Many states require public schools to screen students for scoliosis, usually in the fifth or sixth grade. During the exam, the health professional will ask the child to stand up straight, then bend over and try to touch his or her toes. This bent-over position allows the examiner to check for curvature in the spine, for an abnormal body tilt to the left or right, or for one shoulder blade that is raised higher than the other. The overall value of routine screening is not clear.
Except for osteoporosis-related scoliosis, most cases of scoliosis cannot be prevented. There is no evidence to suggest that improving posture or doing exercises can prevent it. Measures to increase bone mass and strengthen bones, including getting enough calcium and vitamin D, doing regular weight-bearing exercise, and, taking bone-building medications may help to prevent cases caused by spinal fractures. In some cases, early detection may prevent the condition from getting worse.
