Scoliosis Overview

patient-handbook-1

Phase I: Diagnosis

Phase II: Non-Operative

Phase III: Operative

Phase IV: Life After Surgery

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What is Scoliosis?

What is Scoliosis?

Viewed from the front or back, the spinal column should be straight. When scoliosis is present, you will see a sideways shift of the spine to the right or left. When a diagnostic x-ray is done, the curve of the spine is measured in degrees, as an angle (Cobb angle). Scoliosis is defined as a curve greater than 10 degrees. It is most common in the thoracic and lumbar regions of the spine and can involve one or both of these regions. The most common curve pattern is a right thoracic curve. Approximately 10% of the population has small (less than 10 degrees) curves which are of no functional consequence. This condition is called Spinal Asymmetry. There are naturally occurring curves in the spinal column when it is viewed from the side (laterally). Swayback (lordosis) is normally present in the cervical and lumbar regions while roundback (kyphosis) generally exists in the thoracic spine.

 

 

Anatomy of the Spine

The spine is comprised of 24 individual bones called vertebrae that are separated by discs. The discs allow for movement. There are three regions of the spine: 7 cervical (neck) vertebrae, 12 thoracic (chest) vertebrae and 5 lumbar (low back) vertebrae. In addition, there are 5 fused vertebrae that make up the sacrum below the lumbar spine. The spinal column houses and protects the spinal cord. Spinal nerves project out from the spinal cord through space between each of the vertebrae.

What causes Scoliosis?

Scoliosis can arise from a number of underlying conditions, but the most common form is Idiopathic which means “cause unknown.” Scientists have identified that idiopathic scoliosis is a genetic condition and continue to work to isolate the combination of individual genes that cause scoliosis. This may eventually allow for earlier diagnosis and better selections of the “best” treatment for each patient.

There is also some evidence to suggest that uneven growth rates between the anterior (front) portion of the vertebrae and posterior (back) portion of the vertebrae may be one cause of scoliosis.

 

Categories of idiopathic Scoliosis

Idiopathic scoliosis is defined by the age at which it begins to develop. Each age group has unique needs and challenges associated with treatment.

How common is Scoliosis?

Idiopathic Scoliosis is thought to be present in 2–3% of adolescents. 1:500 require active treatment and only  1:5,000 have curves that progress to the degree where surgery is recommended. Girls and boys are equally affected by small degrees of scoliosis. Girls however are much more likely (8X) than boys to develop progressive curves.

 

Other types of Scoliosis

While Idiopathic scoliosis is the most common cause of scoliosis, there are others.


    1. Neuromuscular - an underlying neurologic condition such as Cerebral Palsy, Muscular Dystrophy and Spina Bifida can cause scoliosis to develop.
    2. Congenita l- present at birth, failure of vertebrae to either separate (creating a fused block of vertebrae) or to form completely (hemi-vertebra) can cause uneven growth of the spine and cause scoliosis to develop.
    3. Syndromic - scoliosis is a component of many syndromes such as Marfans and Neurofibromatosis. Scoliosis in syndromes can have characteristics of either neuromuscular, congenital or idiopathic scoliosis.
    4. Other - examples include individuals that have had prior heart or chest surgery may develop scoliosis from weakness of the chest wall.

 

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