Scoliosis is a musculoskeletal condition characterized by a lateral curvature of the spine. When viewed from the rear, the spine is shaped like a ‘C’ or an ‘S’ depending on the extent of curvature. The spine is normally in a straight line when viewed from the back, although there are natural curves when viewed sideways.
Scoliosis affects up to 7 million people in the US alone. Up to 3% of the population also has a curvature of 10 degrees or less, which are asymptomatic; thereby, these people are not aware that they have the condition unless accidentally seen on routine X-rays. Scoliosis is more common in females that are in their late childhood years.
Scoliosis can be classified into congenital, idiopathic or neuromuscular.
- Congenial Scoliosis. Congenital scoliosis involves anomalies in the vertebrae at birth. This can be traced during the third to sixth week of fetal development wherein the spinal formation has been impaired. Most common etiologies include failure of segmentation or failure of formation of the spine.
- Idiopathic Scoliosis. From the term itself, idiopathic scoliosis has no clear cause. It can occur during infancy, childhood, adolescent and adult years. Idiopathic scoliosis is seen to be self-limiting and harmless.
- Neuromuscular Scoliosis. Neuromuscular scoliosis is the most common cause for scoliosis developing later in life. This can be caused by physical trauma, atrophy of the muscles on the spine or cerebral palsy. Physical trauma may include lifting heavy weights on one side of the body that causes the ligaments, tendons as well as the spinal joints to be injured.
Scoliosis is also associated with other conditions such as Marfan’s syndrome, Prader–Willi syndrome and Ehlers–Danlos syndrome, which all affect the musculoskeletal system. Scoliosis that develops later in life when the patient has achieved spinal maturity rarely leads to complications. Scoliosis that have developed earlier can lead to possible complications such as diminished lung capacity, heart compression and reduced mobility because of worsening of the curvature.
Signs and Symptom of Scoliosis
Aside from the lateral curvature of the spine as seen in X-rays, scoliosis can lead to the following manifestations:
- Uneven muscles on one side of the vertebrae
- Uneven lengths of the arms and legs
- Uneven hips
- Prominent shoulder blade or rib on the area of curvature
Scoliosis can also develop on the various areas of the spine although the most common location is on the thoracic vertebrae.
Scoliosis is diagnosed using X-rays since the lateral curvature can be easily seen using radiography. However, in growing patients, an MRI can also be done to assess the development of the spinal cord.
Prognosis of Scoliosis
The prognosis of scoliosis depends on the type as well as the progression of the deformity. Larger curves tend to be more severe as they can lead to severe compression of the thoracic organs. Smaller curves may not actually pose a serious risk. Also, thoracic scoliosis has higher risks for complication than lumbar or thoracic lumbar curves. Those who developed scoliosis before the adolescence years may also be at risk for higher progression as the spine has to develop with the abnormal curves.
Scoliosis, when not managed promptly, can lead to complications such as reduced capacity of the lungs as well as heart compression because the curvature alters the space within the thorax. In this line, managing scoliosis at early stages deems to be essential in maintaining optimum musculoskeletal functioning.