Scoliosis: Check your Curves Early

What do Elizabeth Taylor, Renee Ruso, Isabellayou or someone you love has scoliosis. If you
Rossellini, and Linda Blair all have in common?notice any one or more of these signs, you
Aside from the obvious fact that they areshould schedule an exam with a doctor:
popular and gorgeous celebrities, these women· Shoulders are different heights; one
suffer from a back problem called scoliosis.shoulder blade is more prominent than the other
Scoliosis is a medical condition that is characterized· The head is not centered directly above
by the presence of curvatures and deformities inthe pelvis
the spine. Unlike poor posture, these curves can· Appearance of a raised, prominent hip
not be corrected by simply learning to stand up· Rib cages are at different heights
straight.· Changes in look or texture of skin overlying
Scoliosis affects a small percentage of thethe spine like dimples, hairy patches, color changes
population, or approximately two percent.· Uneven waist
However, scoliosis runs in families. If someone in· Leaning of entire body to one side
the family has scoliosis, the likelihood of anIf someone is suspected with scoliosis, it is usually
incidence is approximately 20 percent. Scoliosis inconfirmed with an x-ray, spinal radiograph, CT
skeletally immature individuals is classified by age:scan, MRI or bone scan of the spine. The curve is
infantile (0 to 3 years); juvenile (3 to 10 years);then measured by the Cobb Method and is
and adolescent (over 11 years, or from onset ofdiscussed in terms of degrees. The Cobb method
puberty until skeletal maturity). In addition, scoliosishas several advantages over other methods,
is classified by etiology: congenital, idiopathic orincluding the fact that it is more likely to be
neuromuscular.consistent even when the patient is measured by
Congenital scoliosis results from embryologicalseveral different examiners. An alternative
malformation of one or more vertebrae and maysystem, known as the Risser-Ferguson method, is
occur in any location of the spine. This is due to aused far less commonly. Generally, a curve is
problem with the formation of vertebrae or fusedconsidered significant if it is greater than 25 to 30
ribs during prenatal development. The vertebraldegrees. Curves exceeding 45 to 50 degrees are
anomalies cause curvature and other deformitiesconsidered severe and often require more
of the spine and lead to differential growth. Thisaggressive treatment.
means that one area of the spinal columnThe traditional medical management of scoliosis is
lengthens at a slower rate than the remainder.determined by the severity of the curvature,
Because these anomalies are present at birth,skeletal maturity, and likelihood of progression.
congenital scoliosis is usually detected at aThe conventional options are initially through
younger age than is idiopathic scoliosis.observation, followed by bracing and surgery.
Idiopathic scoliosis refers to a spinal curve forMost cases of adolescent idiopathic scoliosis that
which there is no discernible cause, and it typicallyare less than 20 degrees require no treatment,
occurs in children and adolescents who arebut should be checked often around every 6
otherwise healthy. It is of unknown cause, andmonths. As curves get worse which is above 25
appears in a previously straight spine.to 30 degrees, bracing is usually recommended to
Neuromuscular scoliosis is caused by problemshelp slow the progression of the curve. Curves
such as poor muscle control or muscularthat are greater than 40 degrees usually require
weakness or paralysis due to diseases such assurgery because curves this large have a high risk
cerebral palsy, muscular dystrophy, spina bifida,of getting worse even after bone growth stops.
and polio. It encompasses scoliotic spineScoliosis is a common problem that usually
deformities that are secondary to neurologic orrequires only observation with repeated
muscular diseases. Etiologies of this type ofexamination in the growing years. Still, early
scoliosis include cerebral palsy, spinal cord trauma,detection is important to make sure the curve
muscular dystrophy, spinal muscular atrophy, anddoes not progress. In the relatively small
myelomeningocele. Spinal deformities that resultpercentage of scoliosis that need medical
from neuromuscular etiologies generally progressintervention, advances in modern orthopedic
more rapidly than idiopathic scoliosis and are moretechniques have made scoliosis a highly
difficult to manage non-surgically.manageable condition.
There are several "warning signs" to determine if