Information From Your Health Care Provider

SCOLIOSIS

(Curvature of the Spine)

Basic information

description

Scoliosis is an abnormal, side-to-side curve of the spinal column. It can involve the thoracic (middle) spine, the lumbar (lower) spine, or the thoracolumbar (between the two areas). It most often affects children during their growth spurt just before puberty. It is more common in girls than in boys. Adults can also be diagnosed with scoliosis.

FREQUENT SIGNS & SYMPTOMS

No obvious symptoms or signs in the early stage. It comes on gradually. Scoliosis can be detected by a health care provider with a simple screening test. Schools sometimes have scoliosis screening programs.
Entire body may lean to one side.
The hip, shoulder, or rib cage on one side of the body is higher than the other side.
Head may be off center.
One shoulder blade is more prominent.
Waist is uneven.
May walk with a rolling gait.
May have back pain or tire easily.

causes

Most often the cause is unknown (called idiopathic scoliosis).
Scoliosis is sometimes a result of:
- A disease of the central nervous system, such as cerebral palsy or muscular dystrophy.
- Congenital (being born with) defects of the spine.
- Uneven leg length.

risk increases with

Family history of scoliosis.

PREVENTIVE MEASURES

Cannot be prevented at present.

expected outcomes

Mild curves may not require treatment. If treatment is done, the outcome is usually successful.

possible complications

Severe curving of the spine and ribs.
Social embarrassment, due to wearing a brace.
Complications such as lung and heart damage, loss of bone strength, and back pain may occur. These are more likely when scoliosis is more severe and goes untreated.
Complications can occur with scoliosis surgery.

diagnosis & treatment

general measures

Your child's health care provider can diagnose scoliosis with a physical exam. An x-ray may be done to confirm the diagnosis. The amount of curve in the spine is measured by degrees.
Treatment will depend on the age of the child, how severe the curve is, and how much it is progressing.
Many cases of scoliosis are minor (less than 20 degrees) and require no treatment. Follow up medical exams will be done to see if the problem is progressing.
For children with more of a curve (usually 25 to 40 degrees), treatment often involves wearing an orthopedic back brace. Sometimes this is needed for several years. Some braces are less visible and permit the person to wear regular clothes.
Surgery to correct scoliosis is typically advised if the curve is more than 40 to 50 degrees or bracing is not helping. Surgery can help improve posture and back function.
For adults with scoliosis, physical therapy or exercises to strengthen back muscles are sometimes helpful. Talk to your health care provider.
To learn more: National Scoliosis Foundation, 5 Cabot Place, Stoughton, MA 02072; (800) 673-6922; website: www.scoliosis.org.

medications

Drugs will not correct this disorder.

activity

Special exercises may be part of therapy. If a brace is necessary, sports participation will be restricted. Some activities, such as swimming, may help since they tone and strengthen the back.
If surgery is done, activities will be limited for several months. This allows time for healing.