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    Everything You Need To Know About Scoliosis

    Britain's Princess Eugenie made a bold attempt by wearing a backless wedding dress which showed a scar that ran down her spine. The princess did not wear a veil with the dress in order to reveal a scar from a major operation on her back to treat scoliosis at the age of 12. Scoliosis is a condition where your spine curves and forms a C or S shape.

    According to the American Association of Neurological Surgeons, scoliosis is an abnormal lateral curvature of the spine which is most often diagnosed in early adolescence and childhood. However, the primary age of onset for scoliosis between 10 to 15 years old.


    The largest study 'Vertebral and Intraspinal Anomalies in Indian Population with Congenital Scoliosis: A Study of 119 Consecutive Patients' was done on total 119 patients with congenital scoliosis who had surgery between December 2006 and December 2012. The results said that thoracolumbar curve was seen in 43.6 per cent of patients, kyphosis was seen in 26 per cent of patients, vertebral anomaly was seen in 51.2 per cent of patients and intraspinal anomalies were seen in 47 per cent of patients with congenital scoliosis in the Indian population.

    What Is Scoliosis?

    The normal spine of a human being is characterized by a curve at the top of the shoulder and a curve at the lower back. But, if your spine is curved in an S or C shape or from side to side, chances are you have scoliosis. Usually, this curve doesn't affect your health or appearance but, it gets worse over time which can cause back pain and other health problems.


    Common Types Of Scoliosis

     Idiopathic scoliosis is the most common type of scoliosis, that has no definite cause. The types of scoliosis include the following:

    Congenital scoliosis

    In this type of scoliosis, the spinal deformities are developed in the womb. During the foetus development, malformation of the vertebrae is one of the most common causes of congenital scoliosis. The symptoms of congenital scoliosis are tilted shoulders, uneven waistline, head tilt and an overall appearance of leaning to one side of the body.

    Neurological scoliosis

    In this type, nerve abnormalities affect muscles in the spinal cord, brain and the muscular system. Neurological scoliosis happens when the nerves and muscles are unable to maintain a proper aliment of the spine. The first sign of neurological scoliosis is a change in posture.

    Degenerative Scoliosis 

    It is also known as adult onset scoliosis, late onset scoliosis or de novo scoliosis. It happens when a sideways curvature of the spine is developed slowly over time. It most commonly occurs in the lumbar spine of the lower back and forms a C shape. The common symptoms are a dull ache or stiffness in the lower back, a tingling sensation in the legs, a sharp pain in the legs while walking.

    Syndromic Scoliosis

    It is a form of scoliosis that develops secondary to syndromes like the Rett's syndrome, Beale's syndrome, muscular dystrophy and various connective tissue disorders. The symptoms aren't painful but they can cause discomfort or pain while sitting.

    What Causes Scoliosis?

    These are some of the possible causes of scoliosis:

    • Specific genes which at least one gene is involved in scoliosis.
    • Neuromuscular conditions
    • Congenital scoliosis
    • Leg length discrepancy
    • Osteoporosis
    • Syndromic scoliosis
    • Other causes of scoliosis include carrying heavy backpacks and satchels, connective tissue disorders, bad posture and some injuries.

    Scoliosis can affect both children and adults and the symptoms affect both differently.

    Scoliosis Symptoms In Children

    • The shoulders are at two different heights.
    • The head doesn't look centred with the rest of the body.
    • One hip is higher than the other.
    • The ribs or hips are pushed out.
    • While standing the arms don't hang down straight next to the body.
    • While bending, the two sides of the back are at different heights.

    Scoliosis Symptoms In Adults

    • Uneven hips and shoulders
    • Trouble in walking
    • Lower back bump
    • Numbness, weakness or pain in the legs.
    • Feeling tired
    • Shortness of breath
    • Loss of height
    • Trouble in standing straight
    • Bone spurs
    • Feelingness of full appetite while you eat which happens because your spine is putting pressure on your stomach.

    What Are The Risk Factors For Scoliosis?

    The risk factor for scoliosis include:

    • Age is one of the risk factors as the signs and symptoms often start during a growth spurt before puberty.
    • Family history is another factor.
    • Gender is a risk factor, though both boys and girls develop mild sclerosis but, females are at a much higher risk of curve worsening.

    What Are The Complications Associated With Scoliosis?

    • Adults who had scoliosis when they were small are more likely to have chronic back pain.
    • If scoliosis is severe, the rib cage presses against the lungs and heart, making it more difficult to breathe and harder for the heart to pump blood.
    • Your body appearance starts changing like uneven shoulders, uneven hips, prominent ribs and a shift of the waist and trunk to the side.

    When To See A Doctor?

    If the child has a severe back pain, uneven shoulders or hips or any other symptom of scoliosis, it's time to visit a doctor. However, mild curves in the spine can develop without your notice because they appear slowly and usually don't cause pain.


    Diagnosis Of Scoliosis

    Diagnosis of scoliosis is done through a physical exam, x-ray, spinal radiograph, CT scan or MRI.

    A positive diagnosis of scoliosis is made based on a coronal curvature measured on a radiograph of greater than 10 degrees. Generally, a spinal curve is considered fine if it is greater than 25 to 30 degrees and spinal curves exceeding 45 to 50 is severe.

    X-ray shows the structure of the vertebrae and the outline of the joints. X-ray is done to search for other potential causes of pain which is fractures, deformities and infections, etc.

    A CT scan (Computed Tomography Scan) is done to show the shape and size of the spinal canal, its contents and the structures around it.
    MRI (Magnetic Resonance Imaging) is a diagnostic test that is done to show the spinal cord, nerve roots and the surrounding areas and also the degeneration, enlargement and deformities of the spine.

    When children are diagnosed with congenital scoliosis, it's important to evaluate the neurological, genitourinary and cardiovascular systems.

    Scoliosis Treatment

    The treatment depends on various factors which include the degree of spine curvature, your age, your growth, the amount and type of curvature, and the type of scoliosis.

    The two treatment options are bracing and surgery.

    1. Bracing

    Braces are effective when the patients haven't reached skeletal maturity. If the child is growing and the spinal curve is between 25 and 40 degrees, a brace is recommended to prevent the curve from increasing. Those who are wearing a brace have to wear it 24X7 for maximum effectiveness.

    A person with scoliosis may need to use a brace if they are growing and the spinal curve is more than 25 to 30 degrees; the spinal curve is between 20 and 29 degrees, but it's getting worse; the person has at least two more years to grow and the spinal curve is between 20 and 29 degrees, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases.


    2. Surgery

    In children, surgery is required when the curve needs to be stopped from increasing during adulthood and to diminish spinal deformity. According to the American Association of Neurological Surgeons, most experts recommend surgery only when the spinal curve is greater than 40 degrees and increasing.

    The spinal fusion is a scoliosis surgery which is done by fusing the vertebrae together using a bone graft, rods and screws. The bone graft consists of bone and the rods help to keep your spine straight and the screws help to hold them in place.

    The risks of spinal fusion surgery also follows which are excessive bleeding, failure to heal, nerve damage, pain and infection.

    In older adults, the risks are advanced age, smoking, overweight and having other medical problems.

    Scoliosis if left untreated, can worsen your health problem by causing a chronic back problem, which impacts heart and lung functions. Screening scoliosis takes about 30 seconds and with early detection and diagnosis, people with this condition can lead healthy and happier lives.

    Additional Questions And Answers

    1. How to sleep with scoliosis?

    If you are sleeping on one side, place a pillow between your legs and a rolled towel under your ribs, a small rolled towel at the base of your neck and another pillow at the small of your back.

    2. Can you exercise with scoliosis?

    If a child is suffering from mild scoliosis, soccer is a great exercise that doesn't worsen the condition or increases it. Soccer is a good aerobic sport will help strengthen your core muscles and if the child has severe scoliosis speak to your doctor before playing the sport.

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