An abnormal, side-to-side or "S-shaped" curve in the spine, scoliosis affects an estimated 6 million people in the U.S. The condition appears most often in children, adolescents, and older adults, but can affect anyone. The cause is often unknown, but when there is a family history of scoliosis, it is important to get regular spinal check-ups, there may be a genetic link.

Causes

Scoliosis tends to run in families, but it can have different causes in people of different ages:

  • Scoliosis in children may be due to a tumor, injury, disease, birth defect, or other primary disorder, such as differences in the length of each leg.
  • Scoliosis that appears in adolescence is often idiopathic or has no known cause.
  • Spinal curvature in older adults is often due to degenerative spine disease or scoliosis that developed earlier in life but has just begun to progress.

Signs

From behind, a normal spine runs straight from neck to tailbone (the small bone at the bottom of the spinal column). In someone with scoliosis, however, there is a side-to-side curve greater than 10 degrees somewhere along the spine. Signs of scoliosis may include one of more of these irregular skeletal features:

  • uneven shoulders, waist, hips, or ribs
  • body appearing to lean to one side
  • one shoulder blade jutting out more than the other

Diagnosis

Your doctor will take your medical history and perform a physical evaluation to check for skeletal and muscular abnormalities. If scoliosis is suspected, an X-ray helps the doctor confirm the diagnosis; see the location, shape, and direction of the curve, and measure the angle of the curve so she can monitor the condition over time.

Risk Factors and Potential Complications

Adult degenerative scoliosis can lead to spinal stenosis, or narrowing of the spine. Idiopathic scoliosis does not typically cause stenosis, according to orthopedic surgeon Michael Neuwirth, MD, but if progressive, scoliosis can ultimately trigger chronic pain from disc degeneration (the breakdown of the soft discs that separate the vertebrae) and facet arthritis, which affects joints in the spine. Another reason to get regular check-ups if you are at risk of, or have developed, scoliosis, is because the condition not only affects the spine but, in severe cases, can also injure lung function and very occasionally leads to pulmonary heart disease. If your doctor suspects any of these conditions, additional testing may be necessary.

Treatments

Spinal curves that measure up to 20 degrees are considered mild and can often go untreated and monitored for changes over time. A more severe curve, measuring up to 40 degrees, will require a brace to help prevent further curvature. Braces are individualized and must be worn for specific periods of time every day in order to be effective. If curvature worsens, one of several types of surgery to straighten and stabilize the spine may be recommended.

Michael Neuwirth, MD, reviewed this article.

 

 

Sources:

National Scoliosis Foundation. "Information and Support." Web. Page accessed 18 July 2013. http://www.scoliosis.org/info.php

Mount Sinai Hospital. "Orthopaedics." Web. Page accessed 14 July 2013.
http://www.mountsinai.org/patient-care/service-areas/orthopaedics

National Institute of Arthritis and Musculoskeletal and Skin Diseases. "Questions and Answers About Scoliosis in Children and Adolescents." Web. Page updated October 2012. Page accessed 14 July 2013. http://www.niams.nih.gov/health_info/scoliosis/

Hospital for Special Surgery. "Scoliosis in Adults: An Overview." Web. 6 Sept. 2011. Page accessed 14 July 2013. http://www.hss.edu/conditions_scoliosis-adults-overview.asp