Scoliosis is a deformation of the shape of the spine and chest that can occur at all ages. It is quite common, more common than is generally believed and its frequency varies in different countries.

Scoliosis or any deformity of the spine would not be of much concern to us if it did not lead to serious problems later on – but unfortunately, most of the time if it is not treated early and correctly it has serious consequences. Although some mild cases of scoliosis may not be accompanied by significant problems, in some other cases the deformity will continue to worsen after adolescence with consequences for the young adult.

“Particular importance should be given when, in addition to scoliosis, the child also complains of pain in the back or lower back, in which case immediate examination by a specialist is imperative.”

Scoliosis in children is classified by age: 1.) Infant (0 to 3 years old); 2.) Minor (3 to 10 years old). and 3.) Adolescent (age 11 years or older, or from the onset of puberty to skeletal maturity). Idiopathic scoliosis makes up the vast majority of cases that occur during adolescence. Depending on its severity and the child’s age, scoliosis is treated with close observation and/or surgery.

In children with congenital scoliosis, there is a known increased incidence of other congenital anomalies. These are most often associated with the spinal cord (20 percent), the genitourinary system (20 to 33 percent), and the heart (10 to 15 percent). It is important to perform a neurological, genitourinary and cardiovascular evaluation when congenital scoliosis is diagnosed.

 

Symptoms

Symptoms of scoliosis may include:

• Uneven shoulders.
• One shoulder blade should be more prominent than the other.
• Irregular waist.
• One hip higher than the other.
• Protrusion on one side of the back when bending forward.

 

When to see a doctor?

See your doctor if you notice signs of scoliosis in your child. Mild curves can develop without you or your child knowing because they appear gradually and usually do not cause pain. Occasionally, teachers, friends and fellow athletes are the first to notice a child’s scoliosis.

 

Causes

Doctors don’t know what causes the most common type of scoliosis — although it appears to involve hereditary factors, because the disorder sometimes runs in families. Less common types of scoliosis can be caused by:

• Certain neuromuscular diseases, such as cerebral palsy or muscular dystrophy.
• Birth defects that affect the development of the bones of the spine.
• Previous chest wall surgery as a baby.
• Spinal injuries or infections.
• Abnormalities of the spinal cord.

 

Risk factors

Risk factors for developing the most common type of scoliosis include:

• Age. Symptoms usually begin in adolescence.
• Sex. Although both boys and girls develop mild scoliosis at about the same rate, girls have a much higher risk of the curve worsening and requiring treatment.
• Family history. Scoliosis can run in families, but most children with scoliosis have no family history of the disease.

 

Complications

While most people with scoliosis have a mild form of the disorder, scoliosis can sometimes cause complications, such as:

• Respiratory problems.
• Back problems.

 

Diagnosis

Scoliosis is usually confirmed by a physical exam, x-ray, spine x-ray, CT scan, or MRI. The curve is measured by the Cobb method and diagnosed for severity by the number of degrees. A positive diagnosis of scoliosis is made based on a coronal curvature measured on a posterior-anterior radiograph greater than 10 degrees. Generally, a curve is considered significant if it is greater than 25 to 30 degrees. Curves that exceed 45 to 50 degrees are considered severe and often require more aggressive treatment.

• X-ray: The application of radiation to produce a film or image of a part of the body can show the structure of the vertebrae and the outline of the joints. X-rays of the spine are taken to look for other possible causes of pain, ie infections, fractures, deformities, etc.
• Computed tomography (CT or CAT scan): Diagnostic image created after a computer reads X-rays. It can show the shape and size of the spinal canal, its contents, and the structures around it. Very good at visualizing bone structures.
• Magnetic resonance imaging (MRI): A diagnostic test that produces three-dimensional images of body structures using powerful magnets and computer technology. It can show the spinal cord, nerve roots and surrounding areas.

 

Treatment

When there is a confirmed diagnosis of scoliosis, there are several issues to evaluate that can help determine treatment options:

• Spinal maturity – is the patient’s spine still growing and changing?
• Degree and extent of curvature – how severe is the curve and how does it affect the patient’s lifestyle?
• Position of the curve – according to some experts, thoracic curves are more likely to progress than curves in other areas of the spine.
• Likelihood of curve progression – patients who have large curves before their adolescent growth spurt are more likely to experience curve progression.

 

After these variables are evaluated, the following treatment options may be recommended:

• Observation
• Support
• Surgery

 

Living with Scoliosis

For many people with scoliosis, the condition does not significantly affect their daily life. Regular check-ups, maintaining a healthy lifestyle and engaging in appropriate physical activities can help manage symptoms and prevent progression.

 

Support

Living with scoliosis can present emotional challenges, especially for teenagers. Support groups and counseling can be valuable resources for individuals and their families dealing with the physical and emotional aspects of scoliosis.

It is important to note that early detection and intervention is vital to the effective management of scoliosis. If you suspect scoliosis or notice any unusual changes in posture or spinal alignment, seeking medical advice immediately can make a significant difference to treatment outcomes. Always consult healthcare professionals for personalized guidance based on individual circumstances.

 

Scoliosis in children

Scoliosis, a condition characterized by abnormal curvature of the spine, can affect people of all ages, including children. While the exact cause of scoliosis is often unknown, it is important to treat and manage this condition, especially when it comes to children. In children, scoliosis can present unique challenges as their bodies continue to grow and develop. Spinal curvature can develop during growth, making early detection and intervention essential. Regular check-ups, especially during the growth phases, can help detect scoliosis at an early stage.

Parents play a key role in the journey of children with scoliosis. Understanding them about the condition and its potential impact on their child’s life is the first step. Understanding that each case is unique, with varying degrees of severity, allows for a tailored approach to treatment. Orthopedic specialists may recommend observation, splinting, or, in more severe cases, surgery. The goal is not only to treat the curvature but also to ensure that the child can live a healthy, active life. Physical therapy and exercises can be incorporated into the treatment plan to strengthen the muscles that support the spine and improve overall posture.

Emotional support is just as important. Scoliosis can sometimes affect a child’s self-esteem, especially during adolescence. Encouraging open communication and cultivating a positive body image can help children with the emotional aspects of living with scoliosis. With advances in medical technology, children with scoliosis can continue their daily lives. Regular monitoring, early intervention and a supportive environment are key ingredients to ensure these children can embrace their uniqueness.