The term scoliosis derives from the Greek word “skolios” meaning a curving or bending. The normal spine viewed from an anteroposterior dimension appears perfectly straight. Scoliosis is when a person’s spine is curved from side to side.
Types of Scoliosis
Depending on where in the spine there appears to be a curve, it is divided into cervical, thoracic and lumbar scoliosis. Often enough there can be a curve which affects more than one section of the spine therefore it is referred to as thoracolumbar scoliosis. Depending on which way the convex curve leans, the scoliosis is termed as right or left and referred to as right thoracic scoliosis or left lumbar scoliosis e.t.c. more often, the scoliosis appears with a curve towards the right. Also, thoracic and thoracolumbar scoliosis is more common. Thoracic scoliosis is more evident because with the curving of the spine there is a rib prominence or a prominent shoulder blade, caused by rotation of the ribcage, which is more evident in the thoracic region.
When grouped by age, scoliosis is usually categorized into three age groups:
- Infantile scoliosis: from birth to 3 years old
- Juvenile scoliosis: from 3-9 years old
- Adolescent scoliosis: from 10-18 years old
Other categories related to terms that describe scoliosis are:
- Hereditary scoliosis
- Neuromuscular scoliosis
- Scoliosis in neurofibromatosis
- Scoliosis and Marfan Syndrome
- Scoliosis caused by injuries.
- Scoliosis caused by tumors in the spinal cord.
- Compensatory scoliosis (Herniated disc or more widely referred to as a slipped disc)
- Idiopathic scoliosis
Of all forms of scoliosis, the most common is Idiopathic scoliosis. It is called idiopathic because its cause is unknown. It is a condition which mainly affects young women and it is more common between the ages of 12-15 years of age. It usually appears after the age of 9-10 years old and worsens as the age and height of the child increases.
How is scoliosis diagnosed?
Many times, the diagnosis is made by parents or the child itself. Usually, girls complain to their mother that their skirt does not sit on their waist properly; that it hangs more on one side, or that one strap keeps falling. Mothers also usually see one shoulder being exposed more.
How is a child examined for scoliosis?
The child stands at attention, naked from the waist up and is asked to bend over with knees apart. The spine is observed to assess whether it is straight. If not, then scoliosis is a possibility and the child is sent for an X-ray to confirm the diagnosis. Full-length standing spine X-rays are the standard method of examination. Once the diagnosis is made, the appropriate treatment is provided. In order to provide appropriate treatment, the severity and progression of the scoliosis must be known.
Scoliosis is measured in degrees therefore treatment depends on how many degrees the curvature is. Scoliosis is divided into sections: up to 20°, from 20-40° and over 40°.
Scoliosis with a size of up to 20° is treated by means of kinesiotherapy, swimming and observation, usually every 6 months.
From 20-40° different types of bracing is suggested. Braces are designed to correct the spine or worst case scenario, prevent it from getting worse. Many times it is possible that the scoliosis can become worse in the brace. Braces must be worn unfailingly for at least 20-24 hours, even at night, and for several years. Many times even after the development of a child. Simultaneously, the back muscles must be strengthened with a specially designed exercise program by Kinesiotherapists-Kinesiologists.
Scoliosis over 40° usually requires surgery. Surgical treatment is required so as to correct curves of great magnitude, which if severe, can possibly create pressure in the lungs and heart thus leading to cardiopulmonary insufficiency or even death. For this reason, specially designed metal rods are used for the correction of the curve. These interventions are considered major, but if there are signs, they must be undertaken.
Scoliosis is a condition which more often affects prepubescent and adolescent girls. Scoliosis, in this case, is called idiopathic because its cause is unknown. A rough examination can be made by parents themselves by making the child bend over with stretched knees.
All children, especially girls between the ages of 9-12, should be examined once a year.
In minor cases of scoliosis, up to 20°, the usual treatment is either exercises for correct posture and/or correction exercises, as referred to by certified kinesiologists, kinesiotherapists and physiotherapists.
Finally, all children who wear braces must wear them constantly, for approximately 20 hours per day and at least until the end of their development (this may bring about some risks).