SCOLIOSIS

General Information

DEFINITION--A bending and twisting of the upper spinal column, which is sometimes progressive and distorts the chest and back.

BODY PARTS INVOLVED--The thoracic (middle spine) or the lumbar (lower spine).

SEX OR AGE MOST AFFECTED

• Adolescents.
• Both sexes, but more common in girls.

SIGNS & SYMPTOMS

Early stages:

• No obvious symptoms or signs, but scoliosis can be detected by a doctor or school nurse with a simple screening test.

Later stages:

• Visible curving of the upper body. The spine becomes S-shaped.
• Shoulders become uneven and rounded.
• Sunken chest.
• Swayback.
• One side of the pelvis thrusts forward.
• Back pain.

CAUSES--

Usually unknown. Scoliosis is sometimes a result of:

• Diseases of the central nervous system, such as polio or muscular dystrophy.
• Congenital defects of the spine.
• Uneven leg length.

RISK INCREASES WITH--Family history of scoliosis.

HOW TO PREVENT--Cannot be prevented at present.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• X-ray of the back.

APPROPRIATE HEALTH CARE

• Doctor's treatment and regular examinations.
• Many cases of scoliosis are minor and require little treatment except physical therapy aimed at strengthening back muscles and improving posture.
• For children needing further treatment, it usually involves wearing a orthopedic back brace (sometimes for several years). Newer type braces are less visible and permit the person to wear regular clothes.
• For adults needing treatment, exercises to strengthen back muscles are recommended (exercises will not correct the curvature). A brace is not effective in adults since the spine has stopped growing.
• If legs are of unequal length, a shoe lift for the shorter leg may be prescribed.
• Surgery to correct the deformity (severe cases only).

POSSIBLE COMPLICATIONS

• Severe distortion of the spine and ribs.
• Social embarrassment.
• Breathing difficulty.
• Lung infection.
• Congestive heart failure.

PROBABLE OUTCOME--When diagnosed early, scoliosis can usually be corrected completely. Often a back brace may be required and worn daily for several years.

How To Treat

GENERAL MEASURES----A teenager may be embarrassed to wear a brace. Be sure your teenager understands that the brace is temporary. Explain the eventual consequences of not wearing the brace. Insist on keeping doctor appointments for follow-up evaluation.

MEDICATION--Medicine doesn't correct this disorder. For minor discomfort from muscle imbalance or complications, you may use non-prescription drugs, such as aspirin or acetaminophen.

ACTIVITY--Consult your doctor. Special exercises may be part of therapy. If a brace is necessary, sports participation will be restricted. Some activities such as swimming and horseback riding may be recommended since they tone and strengthen the back.

DIET--No special diet.

Call Your Doctor If

You suspect your child is developing scoliosis.