Scoliosis is a lateral curvature of the spine along with the curvature the spine rotates as well. This makes the deformity a 3 dimensional problem. There are many theories to its development, but none have been scientifically proven. Thus it is given the term idiopathic Scoliosis. Most occur in adolescent females. Scoliosis of unknown cause makes up 75% of cases with neurological and congenital making up 10% each and the remainder is from other causes.
It is 4 times more likely in females, 90% are to the right side. Generally the younger the patient and the larger the curve the more likely it is to progress. In teenage years the curve is not usually painful, and does not cause problems with the nerves exiting the spine. If you are male, have a curve to the left, have pain or nerve problems your Spine Surgeon may order a special scan called an MRI to further investigate.
What to look for
GP or most likely family member may pick it up. There may be prominence in the flank region or asymmetry of skin creases in the mirror. When viewed from behind and bending forward to touch the toes the maybe a rib “hump” and curvature to the spine will be noted as the spine becomes more prominent.
Tests
Examination looking at the curve and its flexibility is undertaken, along with examination of the nerves.
- X-rays – From the front, side and bending
- A CT scan may be ordered
- Or MRI
Treatment
Every effort is made to avoid surgery. Treatment may consist of observation (regular check up to check progression). Sometimes a brace is used to help control the progression.
In some cases surgery will be recommended. The operation is major surgery and the decision to operate is not taken lightly, by all involved. It usually involves the insertion of rods and screws into the spine bone from the back and the fusion of the bones to stop the deformity from progressing. Sometimes this needs to be done from the front. There are many risks from such surgery, and many gains, and this need to be discussed with a surgeon experienced in this type of surgery.
