Musculoskeletal Disorders: Scoliosis

Description

Every spine has natural curves, which round the shoulders and make the lower back curve slightly inward. However, some people have spines that also curve from side to side. This condition of side-to-side spinal curves is called scoliosis. On an x-ray, the spine looks more like an "S" or a "C" than a straight line. Some of the bones in a scoliotic spine also may have rotated slightly, making the person's waist or shoulders appear uneven. Scoliosis affects a small percentage of the population, approximately 2%. However, scoliosis runs in families. If someone in a family has scoliosis, the likelihood of a incidence is much higher-approximately 20%. Although only 10% of those with scoliosis will need medical treatment, it's important for growing children to be checked periodically for any change.

The vast majority of childhood scoliosis is " idiopathic " meaning its cause is unknown. It usually develops in middle or late childhood, before puberty, and is seen more often in girls than boys. Although scoliosis can occur in children with cerebral palsy and muscular dystrophy , most scoliosis is found in otherwise healthy youngsters.

Diagnosis and Treatment

Scoliosis is not preventable, but diagnosis and treatment during a child's growing years is the best way to prevent an existing problem from getting worse. Idiopathic scoliosis can go unnoticed in a child because it is rarely painful in the formative years. Therefore, parents should watch for the signs that scoliosis is beginning, generally when their child is about 8 years of age. These include:

• Uneven shoulders
• Prominent shoulder blade or shoulder blades
• Uneven waist
• Elevated hips
• Leaning to one side

Any one of these signs warrants an examination by the family physician, paediatrician or orthopaedist (specialists in diseases of the muscles and skeleton).
In planning treatment for each child, an orthopaedist will carefully consider a variety of factors, including the history of scoliosis in the family, the age at which the curve began, the curve's location and severity of the curve. Most spine curves in children with scoliosis will remain small and need only to be watched by an orthopaedist for any sign of progression.
If a curve does progress or is severe, 3 options are present:

• An orthopaedic brace can be used to prevent it from getting worse. Children undergoing treatment with orthopaedic braces can continue to participate in the full range of physical and social activities.
• Electrical muscle stimulation , exercise programs, and manipulation have not been found to be effective treatments for scoliosis.
• Surgery . If a scoliotic curve is severe when it is first seen, or if treatment with a brace does not control the curve, surgery may be necessary. In such cases, surgery has been found to be a highly effective and safe treatment.

The information in this page is presented in summarised form and has been taken from the following source(s):
1. The Scoliosis Research Society: http://srs.org/