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Scoliosis is a lateral curvature of the spine. The American Association of Neurological Surgeons (AANS) estimates that scoliosis occurs in approximately 2-3% of Americans. There are several different types.
The most common form of scoliosis is “adolescent scoliosis,” which starts in children from 10-18 years of age, by which time spinal growth has slowed in most children. The cause is not really known. Symptoms of scoliosis include postural abnormalities such as uneven shoulders, asymmetry of the ribs, uneven arm lengths, and so forth. There can be lower back pain. Worsening may occur as the child gets older, although the curvature may slow.
Congenital scoliosis begins in the womb due to malformation of the spinal vertebrae. It is statistically rare. It is estimated to occur in 1 in 10,000 children. As the child grows, the curvature of the spine may develop into an “s” curve, as the body tries to compensate for the lateral (“c”) curvature.
Symptoms include postural abnormalities such as tilted shoulders, an uneven waistline, a prominence of the ribs on one side, head tilt, and an overall appearance of the body leaning to one side. [Ref:https://www.treatingscoliosis.com/blog/scoliosis-types-differences/]
Early Onset Scoliosis
Scoliosis that develops below the age of 10, while children are still growing, is referred to as “early onset” scoliosis. Because growth of the spine is still in progress, the curvature of the spine may worsen, and other problems can develop, including malformed ribs that can result in abnormal lung and heart development.
Neuromuscular scoliosis is caused by disorders of the spinal cord, brain, and muscular system, when they are unable to maintain the proper alignment and balance of the spine and trunk. This curvature is likely to progress into adulthood and may become increasingly severe in patients who are unable to walk. Patients who are confined to wheelchairs may have trouble sitting upright and may tend to slump to one side. Id.
Conditions that result in neuromuscular scoliosis include muscular dystrophy, spinal muscular atrophy, polio, amyotrophic lateral sclerosis, and similar degenerative neurological and myopathic disorders. The “c” curvature usually affects the entire spine and may be severe enough to cause back pain and deformity.
As people get older and develop degenerate back problems, such as degenerative disc disease and degenerative arthritis, they may develop degenerative scoliosis. This can lead to or contribute to back pain and disability.
The curvature of the spine develops because of asymmetrical degeneration (“wear and tear”) of the bony elements of the spine, including the discs and facet joints. That's what leads to the curvature, and a curvature of >10 degrees (“Cobb angle”) indicates scoliosis.
It is most diagnosed in persons at or over the age of 50, who have symptoms that include muscle fatigue, back pain, numbness, pain, or weakness in the lower extremities, postural abnormalities, and balance problems. Falls are common.
Scoliosis should be differentiated from “kyphosis.” which is a forward curvature of the spine. Kyphosis usually affects the thoracic spine. A type of kyphosis that occurs in adolescence is called “Scheuermann's kyphosis.” Symptoms include poor posture, back pain, muscle fatigue, and stiffness in the back. Id.
Kyphosis can also occur in people who develop osteoporosis, with multi-level vertebral compression fractures. Kyphosis leads to loss of height as well as back pain and considerable disability, depending on the severity of the kyphosis.
Diagnosis and Treatment
Scoliosis is usually diagnosed by orthopedic examination, x-rays, and imaging studies of the spine. Treatment may include spinal exercises, braces, and surgery to straighten the spine.