Scoliosis

What is Scoliosis?

The human body is truly remarkable machine. We can move and balance because of natural curves in the spine. However, when curves occur side-to-side, twisting the body, the spine is not aligned properly. This indicates scoliosis is present.

Scoliosis is not a disease-it is a description of abnormal curves in the spine. The condition can affect children, teenagers and adults, with about two percent of females having scoliosis and 0.5percent of males exhibiting the condition in the general population.

Scoliosis ranges in severity and can be the result of a variety of causes. While scoliosis may go virtually unnoticed in some children, the condition can affect a person’s ability to engage in physical activity, and in severe cases may impair the ability to walk, to sit or to lie down comfortable. Congenital spine deformities, genetic conditions, neuromuscular problems and limb length inequality can all be associated with scoliosis, as well as cerebral palsy, spina bifida, muscular dystrophy, spinal muscular atrophy and tumors.

People with a family history of spinal deformity are at greater risk for developing scoliosis. However, more than 80 percent of cases are the result of unknown causes. In fact, most cases are found in otherwise healthy people. The onset symptoms in the majority of these cases occurs in children around the beginning of puberty. There are several warning signs that help diagnose scoliosis. The Adam’s Forward Bend Test is widely considered to be a very accurate method of detecting scoliosis.

Scoliosis is a common condition of the spine affecting both children and adults, whilst a mild scoliosis can go unnoticed, at any age treatment can and should be sought as early as possible. Scoliosis in adults, may have gone undiagnosed in childhood but can be caused by an asymmetrical degeneration of the vertebrae in the spine, most commonly in the lumbar area. Scoliosis in children can present in stages such as in infantile (younger than three years), juvenile (between 3 and 10 years), or adolescent, the causes of which could be abnormally shaped vertebra at birth, neurological reasons or most often idiopathic (unknown).

The deformation of the scoliotic body consist of (Chêneau 1996a, 1996b):

1. Convexities-concavities.

The paired convexities and concavities: in an oblique plane the brace reduces the convexities and transfers tissues from the convex humps in the direction of the concave flat areas. All abnormal protrusions with respect to the normal physiological shape must be submitted to pressure.

2. Sagittal configuration deformity.

Sagittal configuration deformity: often, abnormal thoracic kyphosis and lumbar lordosis is presented in the scoliotic patient.

3. Rotation of the pelvis and shoulders

Torsion of the pelvis and rotation of the shoulders: the brace must produce a detorsion of the pelvis and derotation of the shoulders.

4. Lateral displacement.

The lateral displacement: in a transverse plane the brace establishes a balance of the shoulders and thorax over the sacrum.

The Adam’s Forward Bend Test

Early detection is important in order to minimize the long-term impact scoliosis may have on a person’s quality of life. A simple exam, called the Adam’s Forward bend Test, can be administered to detect unnatural curvature of the spine. Used by pediatricians, in school screenings or at home, the child is asked to lean forward with feet together, bending 90 degrees at the waist. Asymmetry of the trunk or abnormal spine curvature can be easily identified. Once detected, the presence of scoliosis can be confirmed with an x-ray. Younger children should be checked using Adam’s Forward Bend Test every six to nine months from fifth grade through adolescence.

Treatment options

There are various treatments for scoliosis. Several factors should be taken into consideration before recommending a treatment plan, including the severity of the curvature, location of the curve, maturity of the spine, and potential for progression of the curve. One of three treatments is usually recommended: observation, orthopaedic bracing or surgery.