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Scoliosis is a side-to-side curvature of the spine. It can be caused
by congenital, developmental or degenerative problems, but the vast
majority of cases of scoliosis actually has no known cause. By far
the most common form of scoliosis is idiopathic scoliosis which
develops in adolescents and progresses mostly during the adolescent
growth spurt. The cause of idiopathic scoliosis is unknown
(idiopathic literally means “cause unknown”).
Scoliosis usually develops in the thoracic spine (upper back) or
the thoracolumbar area of the spine, which is between the thoracic
spine and lumbar spine (lower back). It may also occur just in the
lower back. The curvature of the spine from scoliosis may develop as
a single curve (shaped like the letter C) or as two curves (shaped
like the letter S).
It is important to note that scoliosis is not typically a cause of
back pain. The condition represents a deformity of the spine but is
usually not painful.
Idiopathic scoliosis is a relatively common
disorder and affects approximately 1 in 1,000 adolescents. It’s
categorized into three age groups, from birth to 3 years old
(infant), from greater than 3 to 9 years old (juvenile), and from
greater than 9 to 18 years old (adolescent). This last category
accounts for 80 percent of the cases. Girls tend to be affected
slightly more often than boys. More importantly, girls are eight
times more likely to need treatment for scoliosis, because they tend
to have curves that are much more likely to progress. For both boys
and girls, the risk of curvature progression is increased during
puberty, when the growth rate of the body is the fastest.
Scoliosis is a term used to describe a condition, but is not a
disease, or a diagnosis. Because idiopathic scoliosis is considered
a deformity, treatment is largely centered on reducing or limiting
the progression of the deformity and is not focused on treatment of
pain.
Diagnosis
Many cases of idiopathic scoliosis are diagnosed using the Adam’s
forward bend test. Students are routinely given this examination in
school to determine whether or not they may have scoliosis. A
physician may also perform this test as part of a routine physical.
The test involves the patient bending forward with arms stretched
downward, while being observed by a healthcare professional. If a
“rib hump” or asymetry is seen, or if the shoulders are different
heights, scoliosis may be suspected. If so, an x-ray may be ordered
to determine the degree of severity of the curve. In rare cases,
especially if the scoliosis may be causing a problem for the
neurological functions of the spinal cord, an MRI may be ordered so
the physician can get a better look at the situation. A diagnosis of
scoliosis does not mean the activity level of the individual should
be restricted, since activity does not affect the degree of the
curve. (Continued
on next page.)
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