Scoliosis

Scoliosis is a spinal deformity that causes an abnormal curvature of the spine. A normal spine when viewed from behind appears straight. A spine affected by scoliosis shows a lateral curvature, giving the appearance that the person is leaning to one side. Often the spine will be shaped like an “S” or a “C.” The curvature must be 10 degrees or greater to be considered scoliosis. Three to five of every 1,000 children will develop some form of spinal curve severe enough to require treatment.

Doctors use different terms to describe the different curvatures of the spine affected by scoliosis:

  • Dextroscoliosis – The spine curves to the right. This deformity usually occurs in the middle to upper section of the back (thoracic spine). This is the most common type of curve and can occur on its own to form a “C” shape, or with another curve to form an “S” shape.
  • Levoscoliosis– Spinal curve is to the left, typically occurring in the lower section of the spine (lumbar). In rare instances when this curve occurs in the thoracic spine, it may be the result of a spinal cord tumor or other spinal abnormalities.

Symptoms

The following are some possible symptoms of scoliosis:

  • Difference in shoulder height
  • Difference in hip height or position
  • Difference in shoulder blade height or position
  • Head not centered properly with the body
  • Difference in the way the arms hang alongside the body even when the person is standing straight
  • Sides of the back appear uneven in height when the person bends over.

In more severe cases, you might experience these symptoms of scoliosis:

  • Shortness of breath or difficulty breathing
  • Chest pain
  • Leg pain
  • Back pain
  • Changes in bowel or bladder habit with difficulty controlling bowel or bladder function

Causes

The majority (85 percent) of all scoliosis cases are classified as idiopathic scoliosis, meaning they have no known cause. The remaining 15 percent of scoliosis cases are linked to causes such as:

  • Neuromuscular conditions – Cerebral palsy or muscular dystrophy can possibly lead to scoliosis.
  • Birth defects – During fetal development, either the bones of the spine fail to separate from one another or they do not form completely
  • Arthritis – Scoliosis caused by arthritis is a degenerative form of the condition and usually occurs only in older adults.
  • Spinal conditions – Conditions that affect the spine and can lead to scoliosis can include osteoporosis, vertebral compression fractures, disc degeneration and spondylosis.
  • Injury – Trauma to the spine

Types

  • Nonstructural scoliosis – The spine is structurally normal and the curve is actually temporary. The condition can be corrected once the underlying cause is identified and treated.
  • Structural scoliosis – The spine has a fixed and more permanent curve. This condition is usually the result of a birth defect, infection, disease or injury.
  • Idiopathic scoliosis – This type of scoliosis refers to the 80 to 85 percent of scoliosis cases for which the cause is unknown. Idiopathic scoliosis is divided into three categories, depending on age range:
    • Infantile idiopathic scoliosis – Affects children under three years of age
    • Juvenile idiopathic scoliosis – Affects children ages three to 10
    • Adolescent idiopathic scoliosis – Affects children (more girls than boys) 10 years of age and older. It's the most common type of scoliosis with an unknown cause. This condition is very likely to run in families.

Treatment

Treatments for scoliosis depend upon the severity of the condition and range from nonsurgical treatments such as pain medications, observation and bracing to more invasive treatments like spinal fusion surgery.

The multidisciplinary team of spine experts at Northwell Health Orthopaedic Institute treats scoliosis as well as a broad range of spine conditions that can occur at any stage of life.

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