Scoliosis

What is Scoliosis?
Scoliosis is an abnormal curvature of the spine. A normal spine when viewed from the back, looks like a straight line but if it has scoliosis, it may look more like an "S" or a "C" on an x-ray.  The curve may be very small- mild (40 degrees).

What are the signs and symptoms of Scoliosis?

• The opposite sides of the body may not appear level.
• Head is not centered
• Shoulders or  hips  are unleveled
• One shoulder blade are more prominent than the other rib cages are at different heights
• Uneven waist line
• Leaning of entire body to one side
• Changes in look or texture of skin overlying the spine (dimples,  hairy  patches, color changes)
• You may walk with a rolling gait.
• You may experience back pain or tire easily during activities that require excessive trunk (chest and belly) movement.

Who are at risk?
If someone in a family has scoliosis, however, the likelihood of an incidence is approximately 20%. Scoliosis affects girls twice as often as it affects boys. About three to five of 1,000 people are affected. Scoliosis usually occurs in those older than 10 years, but the condition can be seen in infants.

What Causes Scoliosis?
In most cases (85%), the cause of scoliosis is unknown (what doctors call idiopathic). The other 15% of cases fall into two groups:

Nonstructural (functional): This type of scoliosis is a temporary condition when the spine is otherwise normal.  The curvature occurs as the result of another problem. Examples include one leg being shorter than another from muscle spasms or from appendicitis.

Structural: In this type of scoliosis, the spine is not normal. The curvature is caused by another disease process such as a birth defect, muscular dystrophy, metabolic diseases, connective tissue disorders, or Marfan syndrome.

How is Scoliosis Diagnosed?
Your doctor will ask about your child's personal and family medical history and may take these diagnostic steps:

Physical examination. Your doctor examines the spine as well as the shoulders, hips, legs and rib cage for signs of scoliosis.

X-rays.  Most doctors can detect even mild curves during a physical exam but use X-rays to confirm and measure the size of the scoliosis.   Periodic X-rays are done to monitor the curve and help make treatment decisions.

Doctors describe a scoliosis based on the shape and size of the curve, the location of the curve and other factors:

•      Shape. Curves develop side to side as a C- or S-shaped curve.
•      Location.  The curve may occur in the upper back (thoracic), the lower back area (lumbar) or in both areas (thoracolumbar).
•      Direction Scoliosis can bend the spine to the left or to the right.
•      Angle   Doctors measure the angle of the curve on X-rays. Scoliosis is defined as a spinal curvature of greater than 10 degrees. Your child’s doctor can compare these measurements over time to see if the curve is getting worse.

What are the available treatment options?
Observation- Most children with scoliosis have mild curves — less than 20 degrees — and probably won't need treatment with a brace or surgery. Periodic checkups and X-rays are needed, though, to be sure the curve doesn't worsen (progress).  Children who are still growing need checkups about every four to six months to see if there have been changes in the curvature of their spines.

What are the possible Complications?
While most people with scoliosis have a mild form of the disorder, scoliosis may sometimes cause complications, including:

• Lung and heart damage.  In severe scoliosis — a curve greater than 70 degrees — the rib cage may press against the lungs and heart, making it more difficult to breathe and harder for the heart to pump.  In very severe scoliosis — a curve greater than 100 degrees — damage to the lungs and the heart can occur. Any time breathing is compromised, the risk of lung infections and pneumonia increases.

• Back problems. Adults who had scoliosis as children are more likely to have chronic back pain than are people in the general population. Also, people with untreated scoliosis may develop arthritis of the spine.

• Body image.  Your child might feel isolated and develop a poor body image from the deformity created by scoliosis during childhood and teenage years.

HOW CAN THE MEDICAL CITY HELP YOU?
At The Medical City we have a complete roster of competent physiatrists who may assess or treat people with different types of scoliosis.

For further inquiries or if you want to seek consult, please call:

PHYSICAL MEDICINE AND REHABILITATION

Tel. no. (632) 988-1000 / (632) 988-7000 ext. 6240 / 6241

CENTER FOR PATIENT PARTNERSHIP
Tel. no. (632) 988-1000 / (632) 988-7000 ext 6444

Note: This information is not intended to be used as a substitute for professional medical advise, diagnosis or treatment.  If you or someone you know have any of the symptoms mentioned above, it is advisable to seek professional help.

References :
www.iscoliosis.com 2007, Medtronic Sofamor Danek
www.MedicineNet.com 1996-2008 MedicineNet, Inc
www.mayoclinic.com1998-2008 Mayo Foundation for Medical Education and Research (MFMER)
www.en.wikipedia.org 2008Wikimedia Foundation, Inc.
www.orthoinfo.aaos.org 1995-2007 American Academy of Orthopedic Surgeons
www.apta.org 2008 American Physical Therapy Association
www.spineuniverse.com/displaygraphic.php/3550/lonner_flatback_fig3e200
-BB.jpg. September4, 2008
www.lifesteps.com/gm/Atoz/ency/spinal_instrumentation.jsp. September 3, 2008