The spine is bent to the side more than 10 degrees while rotating around on its own axis. Scoliosis develops in early ages. It has a faster progression especially in young girls compared to male adolescents.
Classification of the Scoliosis
The scoliosis is structural if the deformity is fixed and accompanied by anatomic changes. In nonstructural scoliosis, the deformity is temporary and can be treated if the posture of the patient is corrected.
Eighty percent of the structural scoliosis is idiopathic (the etiology is unknown). In idiopathic scoliosis, the curve in the spine may be C-shaped or S-shaped. The second most common type is neuromuscular scoliosis, which originates from the muscle and nervous system disorders. The third type, congenital scoliosis develops as a result of the spine anomalies in the womb.
The etiology usually cannot be elucidated. However, trauma, infection of the spine, rheumatic diseases, tumors, connective tissue disorders, and CNS disorders like cerebral palsy and poliomyelitis may be the cause. Another cause of scoliosis is the congenital structural deformities.
If it is not accidentally diagnosed during an x-ray examination or screening, it may remain unrecognized in the early phase of the disease. Nevertheless, parents will usually notice the asymmetry in the child’s spine in the later phases.
How is it Diagnosed?
It can be diagnosed with the help of the findings observed during the physical examination. The most prominent symptom is the asymmetry of the shoulders. It can be easily observed from the back view. If the patient bends forward, the bending is more prominent in one side and the spinal hump is easier observed. X-ray is helpful for the confirmation of the diagnosis and determination of the type and degree of the curve. X-ray examination is repeated in predetermined intervals of the follow-up according to the age at diagnosis.
The follow-up criteria defined in the treatment guidelines should be considered. The treatment programs are chosen according to the calculation of the progression risk and the age at diagnosis. Follow-up in certain intervals according to the degree and progression risk of scoliosis, brace applications, tailor-made scoliosis exercises and rehabilitation programs and eventually surgical interventions can be tried.
This may progress parallel to the growth rate in the childhood and adolescence. Although some patients need only follow-up, corset and surgical intervention can be preferred if the curve shows a fast progression. The treatment method should be chosen according to the age at diagnosis, the degree of scoliosis, progression rate in the x-ray examinations and findings in the physical examination.