Scoliosis Health Article

Definition

Scoliosis is a curving of the spine. The spine curves away from the middle or sideways.

Alternative Names

Spinal curvature; Kyphoscoliosis

Causes, incidence, and risk factors

There are three general causes of scoliosis:

• Congenital (present at birth) scoliosis is due to a problem with the formation of the spine bones (vertebrae) or fused ribs during development in the womb or early in life.
• Neuromuscular scoliosis is caused by problems such as poor muscle control or muscle weakness, or paralysis due to diseases such as cerebral palsy, muscular dystrophy, spina bifida, and polio.
• Idiopathic scoliosis is scoliosis of unknown cause. Idiopathic scoliosis in adolescents is the most common type.

Some people may be prone to curving of the spine. Most cases occur in girls. Curves generally worsen during growth spurts. Scoliosis in infants and young children are less common, and commonly affect boys and girls equally.

Symptoms

A doctor may suspect scoliosis if one shoulder appears to be higher than the other, or the pelvis appears to be tilted. Untrained observers often do not notice the curving in the earlier stages.

Other symptoms can include:

• Backache or low-back pain
• Fatigue
• Shoulders or hips appear uneven
• Spine curves abnormally to the side (laterally)

There may be fatigue in the spine after prolonged sitting or standing. Pain will become persistent if there is irritation to the soft tissue and wear and tear of the spine bones.

Note: Kyphoscoliosis also involves abnormal front to back curvature, with a "rounded back" appearance. See: Kyphosis

Signs and tests

The health care provider will perform a physical exam, which includes a forward bending test that will help the doctor define the curve. The degree of curve seen on an exam may underestimate the actual curve seen on an x-ray, so any child found with a curve is likely to be referred for an x-ray. The health care provider will perform a neurologic exam to look for any changes in strength, sensation, or reflexes.

Tests may include:

• Scoliometer screening (a device measures the curvature of the spine)
• Spine x-rays (taken from the front and the side)
• MRI (if there are any neurologic changes noted on the exam or if there is something unusual in the x-ray )