SCOLiOSiS: What is Scoliosis?
What is Scoliosis?
Scoliosis is an abnormal sideways curvature of the mid back and/or the lower back. Most cases of scoliosis arise due to an unknown origin, called idiopathic scoliosis. Scoliosis impacts females more than males and is most often detected during the growth spurt from ages 10 to 18.
The incidence of scoliosis varies in different countries and among different references between 2% and 13.6% (Weinstein et al., 2008). Scoliosis is considered one of the main musculoskeletal changes of adolescence and is the most common spinal disorder in childhood (de Assis et al., 2021).
Scoliosis is a progressive and deforming musculoskeletal dysfunction of the spine. If an abnormal curve of the spine is detected, it should be monitored to prevent curve progression.
Adolescent idiopathic scoliosis is found predominantly in adolescent females, with a 10:1 ratio of female to male (Adhoot, Fan, & Aminian, 2021). Adolescent idiopathic scoliosis is the most common form of scoliosis and is distinguished from other types of scoliosis by the absence of underlying congenital or neuromuscular abnormalities (Kuznia, Hernandez, & Lee, 2020).
Adolescents with scoliosis have the highest risk of curve progression during the period of rapid growth prior to skeletal maturity. Females should be checked for scoliosis from ages 10 to 12 and males should be checked from ages 13 to 14 (Zapata, Sucato, & Jo, 2019).
Types of Scoliosis:
· Idiopathic scoliosis = scoliosis that arises due to an unknown cause
· Congenital scoliosis = scoliosis that develops before birth
· Neuromuscular scoliosis = scoliosis caused by a disorder such as cerebral palsy, spina bifida, or muscular dystrophy
· Degenerative scoliosis = scoliosis that develops in the lumbar spine due to “wear and tear”
Signs of Scoliosis:
· Sideways curvature of the middle or lower back
· One shoulder is higher than the other
· One hip is higher than the other
· One scapula is more prominent than the other
How Scoliosis Can Impact Your Health:
· Aesthetic changes
· Musculoskeletal restrictions
· Back pain
· Severe scoliosis may be associated with respiration dysfunction or heart damage
Risk Factors for Scoliosis
The causes of scoliosis vary and are classified broadly as congenital, neuromuscular, idiopathic, and spinal curvature due to secondary reasons such as degeneration (Janicki & Alman, 2007). 80% of cases of scoliosis in childhood are idiopathic, meaning they arise from an unknown origin (Negrini et al., 2012).
Schoolchildren are more susceptible to scoliosis because they go through a rapid growth phase in adolescence, are sedentary at school, and have a low daily level of physical activity. Schoolchildren being classified as irregularly active is considered a risk factor for the development of scoliosis (de Assis et al., 2021).
Contributing factors to Scoliosis: (Karimi & Rabczuk, 2018)
Genetic predisposition
Hormonal dysfunction
Change in bone mineral density
Abnormal platelet calmodulin levels
Biomechanical factors
Central nervous system abnormalities
Lack of physical exercise
Poor posture
Neuromuscular conditions
Birth defects
Spinal infection
Potential Complications of Scoliosis:
Not all patients with scoliosis will experience symptoms. While some people may experience back pain, others may not.
Complications may occur due to severe scoliosis. With a severe scoliosis it is possible to have rib deformities, pulmonary dysfunction, and even heart problems. These complications are rare, but they may occur in severe cases.
Scoliosis Screening
If you think that you or a family member may have scoliosis, you should get it checked sooner rather than later to prevent curve progression. An initial screen will be performed including a posture analysis and a forward bend test. The posture analysis and forward bend test will provide initial information to the practitioner that there may be a scoliosis curvature.
If there is suspicion of scoliosis, your healthcare provider may recommend having an X-ray analysis performed to confirm the diagnosis. On the radiograph your practitioner will evaluate the Cobb Angle of the curvature. A Cobb Angle of more than 10 degrees is considered scoliosis.
A complete analysis will include a case history, physical examination, and radiographs. Your practitioner will evaluate your spine and check for musculoskeletal restrictions such as decreased range of motion, neurologic symptoms such as poor balance, and functional deficits such as gait abnormalities.