Scoliosis

  • Abnormal three dimensional curvature of the spine, typically diagnosed in childhood or early adolescents 

  • Primary age of onset: 10-15 for idiopathic adolescent scoliosis (Most Common)

  • Every year, scoliosis patients make more than 600,000 visits to private physician offices, an estimated 30,000 children are fitted with brace and 38,000 undergo spinal fusion surgery

  • 3 types of scoliosis

    • Idiopathic: 80% of cases, usually diagnosed during puberty 

      • Infantile: 0-3 years diagnosed (1%)

      • Juvenile: ages 4-10 (10-15% of population) → tend to have more cardiac abnormalities and if curve is > 30 degrees it is more likely for it to progress

        • 95% of these need surgical procedure 

      • Adolescent: ages 10-18, 90% of population (Most Common Type)

    • Congenital: due to embryological malformation, may also cause other deformities of the spine, detected earlier than idiopathic 

    • Neuromuscular scoliosis: result of neuromuscular conditions present such as CP, spina bifida, muscular dystrophy 

      • Progresses more rapidly, more likely for surgical intervention 

  • Signs/Symptoms:

    • Three dimensional curvature of the spine, one shoulder higher than the other, sideways posture, clothes not hanging equally, muscle aches, decreasing pulmonary function (red flag)

  • Diagnosis: X-Ray, CT, MRI, physical exam 

    • Adam’s forward bending test (explained in the educational video)

  • Treatment: conservative 1st → fix muscle imbalances, possible bracing. 

    • Progressive scoliosis/>50 degree curve: possible spinal fusion

    • Bracing: > 20 degrees 

      • COMPLIANCE with brace is VERY importance to help prevent curvature progression

    • Schroth treatment approach: elongation of the trunk, correct muscle imbalances, stability

      • Education on posture awareness and breathing into the concave of the spine. 

    • SEAs (scientific exercises approach to scoliosis) 

      • Increasing spinal stability

      • Retrain the brain - active self correction of the curvature/spine

      • Improving balance reactions

  • NOTE:

    • If you are an adolescent still in the growing phase of life, please go see your local orthopedic surgeon to get x-rays and measured for possible custom bracing to prevent progression of the curvature