Definitions: what is scoliosis?
Scoliosis is a spinal deformity linked to a torsion of the vertebra in relation to the three planes of space (up-down, right-left, front-back). It appears mostly in adolescence, then childhood but can also happen during adulthood.
This condition is sometimes the consequence of another illness or deformation, however, the causes are often unknown. It is known as idiopathic scoliosis when no cause can be found, and secondary scoliosis when it’s caused by a muscular or bone disease.
Besides a torsion of the spine, scoliosis also can have effects on the thorax, abdomen, as well as areas around the spine.
Causes: why does scoliosis appear?
70-80% of cases are idiopathic scoliosis and progressively develops through growth. It develops slowly before and accelerates during puberty, due to growth spurts during this time. It is the most common form in the 8-15 age group and mostly affects girls (8 times more often than boys).
Secondary scoliosis can be caused by a neuromuscular or bone disease, or by a birth deformation. Furthermore, degenerative scoliosis or “de novo”, is scoliosis found later on in life. It is caused by a deterioration of the intervertebral and vertebral disks linked to age. Degenerative scoliosis is all the more common, as duration of life consistently increases.
Symptoms: how to detect scoliosis
Scoliosis doesn’t cause a particular pain, which is why it usually goes undetected during the early stages. However, in adulthood, it can cause back pain. In case of scoliosis, it’s possible to notice poor posture, including a hump on one side of the back when the person leans forward.
It’s this hump that the doctor usually looks for during a medical examination to confirm the diagnosis. To accomplish this, the doctor will ask the patient to do different positions that would reveal this deformation. If scoliosis is detected, other exams including radiographs can be done to find out more.
Moreover, you must not mistake scoliosis for another illness that doctors call habit scoliosis. This illness is characterised by a reducible deviation and is generally caused by poor posture.
Treatment: how to correct scoliosis
Scoliosis treatment is a long-term treatment that can be spread out over several years. If the deviation of the spine is weak, special treatment is not necessary, if not only a medical follow-up, especially in early adolescence.
When scoliosis reaches 15-20% of the strain, it must be treated by wearing a brace which prevents the scoliosis from worsening and straightens the curvature. Children must wear the brace at all times (except in the bathroom) and it must not be taken off until the skeleton is mature, and the shape is fixed. The aim is to reduce the curvature as much as possible by the time the child stops growing.
For adults, wearing a brace can reduce possible pains and slow down the development by reestablishing a certain balance within the spine. This is usually worn at the same time as doing physical therapy sessions which will help with mobility of the spine and also reinforce the associated muscles.
In cases where scoliosis is more serious, or that despite wearing the brace, the deformation goes beyond 35%, surgical treatment is necessary. Operations can be done on young children as well as adults but are more serious. They consist of correcting the deformation by using metal rods, implanted in the spine.
When you can, it is also possible to treat the cause of scoliosis directly at the source (a spinal deformation, a strain, a foramen magnum that’s too narrow…)