Scoliosis is medical term given to a condition in which a patient?s spine is curved sideways. Usually it is ?s? shaped but may also be rotated. In this condition the bones of the spine are generally twisted on each other. Scoliosis has a sexual preponderance; it is two times more common in girls than boys. In adults this condition is very painful even on X-Ray the spine may look like ?S? or even ?C? rather than a straight line. It can be congenital or idiopathic in nature. Idiopathic Scoliosis is classified either according to the age of onset or if the Scoliosis has developed as a symptom secondary to some other medical condition like physical trauma, Cerebral Palsy, Spinal muscular atrophy and many others.

 

Scoliosis is medical term given to a condition in which a patient’s spine is curved sideways. Usually it is “s” shaped but may also be rotated. In this condition the bones of the spine are generally twisted on each other. Scoliosis has a sexual preponderance; it is two times more common in girls than boys. In adults this condition is very painful even on X-Ray the spine may look like “S” or even “C” rather than a straight line. It can be congenital or idiopathic in nature. Idiopathic Scoliosis is classified either according to the age of onset or if the Scoliosis has developed as a symptom secondary to some other medical condition like physical trauma, Cerebral Palsy, Spinal muscular atrophy and many others.

Classification of Scoliosis – Scoliosis can also be classified based on the curvature of the spine in relation to central axis.

• Dextroscoliosis – Right side convexity of spine
• Levoscoliosis – Left side convexity of spine
• Rotoscoliosis – Results due to rotation of vertebrae on their axis

Classification of Scoliosis – based on development of the curvature.

• Congenital
• Infantile Idiopathic Scoliosis
• Juvenile idiopathic Scoliosis
• Adolescent idiopathic Scoliosis
• Scoliosis can be Neuromuscular in which there is defect in formation of spine so it can also be considered as Congenital Scoliosis
• Spinal Arthritis can result in weakening of the ligaments near the spine which may lead to abnormal curvature which is known as Degenerative Scoliosis
• There may be some other causes of Scoliosis like some spinal tumors

Signs and Symptoms

• First changes include abnormal curvature of spine
• Head appearing off center
• Uneven hips or shoulders
• Fatigue
• Back Pain
• Shortness of breath
• Chest pain
• Local muscular aches

Diagnosis and Tests for Scoliosis

 

• Physical examination of the patient is done by looking from every possible side while the patient is bent down and is undressed above waist
• X – Ray films are obtained to confirm the diagnosis and they are also useful in the measurement of the curve. Curves more than 20 degrees require treatment

Treatment and Medicines

Treatment modalities include -

• Bracing
• Surgery

As a routine, regular check-ups and periodic X-Rays are indicated in the patients with Scoliosis to monitor the curve and to look if it is worsening. There are guidelines to treat Scoliosis depending on whether it is mild, moderate or severe in curvature. In spite of treatment guidelines the decision to treat the Scoliosis is always made after considering family history, age and health conditions on a case to case basis.

• Bracing – Bracing is normally prescribed to the patients who are in their age so as to prevent the curvature of the spine being getting worse to the point which requires surgery. Braces are sometimes also prescribed to the adult patients to relieve the pain. Most commonly used brace is the TLSO which is generally made up of fiberglass or plastic. It fits from armpits to hips and applies pressure sideways on the curve. It is worn more than 20 hours per day. In infants serial plaster casts are applied instead of braces and they have proven to cure such cases permanently.
• Surgery – Surgical options include spinal fusion with instrumentation and surgery without fusion using Vertical Expandable Titanium Prosthetic Ribs (VETPR)
• Other treatment modalities include Chiropractic and Physical Therapy