According to the American Association of Neurological Surgeons, as many as 9 million people in the United States have scoliosis. While there is often no identifiable cause behind this lifelong condition, there are proven strategies and methods to monitor scoliosis, as well as treatments to prevent the condition from worsening.
“Early identification of scoliosis is important to maintain a child’s activity levels and quality of life,” says Colin Harris, MD, orthopedic spine surgeon at Atlantic Health System. “While most cases of scoliosis don’t require bracing or surgery, it’s important to monitor the condition and ensure prompt treatment if it’s ever needed.”
What is scoliosis?
While most people have a bit of a bend to their spine, scoliosis is diagnosed when the curvature goes beyond the normal variation. Scoliosis can occur in the lumbar (lower) section of your spine or the thoracic (middle) section. Cases that affect the lumbar spine are more likely to progress because there is more movement in that portion of your spine.
There are a few different types of scoliosis. Dr. Harris says more than 80% of scoliosis cases are idiopathic, meaning there is no known cause. However, he says that there can be a genetic component to the disease and that it sometimes runs in families. While body mechanics might also play a role in the development of scoliosis, heavy backpacks or contact sports do not.
Neuromuscular scoliosis and syndromic scoliosis are two other types of the disease, but Dr. Harris says they are generally linked to a known condition such as muscular dystrophy or cerebral palsy.
How is it diagnosed?
Scoliosis is often seen as an ‘S’ or ‘C’ curvature of the spine. Many schools provide screenings for scoliosis and the condition is often first identified by a school nurse or your child’s pediatrician by using an Adam’s forward bend test. Dr. Harris says that sometimes parents will notice their child has one shoulder that sits a little higher than the other, which can also be a sign of the condition. A frontal X-ray and curve greater than 10% are required to diagnose scoliosis.
Scoliosis can range from mild to severe, but it is generally not painful and doesn’t cause any issues with walking, running or playing. While children and adults of any age can develop scoliosis, Dr. Harris explains that the condition is most often diagnosed in children between the ages of 10 and 14. Adults are often diagnosed with scoliosis later in life due to osteoarthritis or another degenerative bone disease.
Scoliosis treatment
While the condition cannot be cured, Dr. Harris says that more than 90% of people with scoliosis do not require treatment. However, when the spine curves significantly, bracing or surgery might be necessary to prevent the disease from progressing.
Observation
For children and adults who have a mild curvature of less than 20 degrees, observation and X-rays to monitor the condition are recommended.
Bracing
For curvatures between 25 and 40 degrees, scoliosis bracing might be required. Dr. Harris says that bracing is only recommended for children who have at least two years of spinal growth remaining. The time a child will wear a scoliosis brace will depend on several factors, including a child’s growth rate and pattern, as well as the severity of their condition
Surgery
In cases of scoliosis that cause a curve greater than 50 degrees or for adults with the condition, spinal fusion surgery to stabilize the spine and correct the condition is recommended.
“The good news is that we have a lot of resources to manage scoliosis and most children with the condition can lead a very normal life,” says Dr. Harris. “Careful management throughout a patient’s lifetime will minimize the impact of scoliosis and prevent the need for surgery in the future.”
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