Scoliosis

Scoliosis is a condition where the curvature of the patient’s spine deviates from the normal alignment and curves sideways. A person with Scoliosis will have a spine that protrudes on the side when looking from the front of an X-ray, forming an S-shape. Scoliosis targets no specific age and can be present at the time of birth because it is mostly hereditary, but people who still don’t have fully developed spines are more susceptible to this condition.

Types of scoliosis are classified into:

1. Infantile Idiopathic Scoliosis – This type of scoliosis is present in infants and children not older than 3 years of age. Aside from the vertebrae birth defect, the cause of this type is unknown, as to why it is classified as idiopathic.
2. Congenital – This is mainly hereditary scoliosis that is present at birth which requires a more aggressive treatment to prevent the development of a misshaped spine.
3. Juvenile Scoliosis – This type develops among children age 3 to 10 years.
4. Adolescent Idiopathic Scoliosis – This happens to people over ten years of age, when the spine is developing rapidly.

Other types of scoliosis include the functional type, where the patient’s spine is normal but the deformity is due to other health problems in the body. Physical defects and effects include unparalleled limbs and muscle spasms. Another type is degenerative scoliosis, which happens among the elderly due to alterations in the spine caused by arthritis. Lastly, neuromuscular scoliosis is characterized by undeveloped bone formation.

Causes

Although the main cause of pre-pubescent and the early onset of scoliosis is still unknown in medical science, genetics is the main reason for this condition. A mother with scoliosis is most likely to give birth to an infant with congenital scoliosis. As a result of a decade of study and tests, the American Journal of Human Genetics recently found the first gene to be linked to its cause called CHD7.

Women are more prone to scoliosis rather than men, and females aging 10 and above are mostly at risk. When the scoliosis is congenital, it is due to genetics and in some cases, because of an irregularity called tethered spinal cord that limits the movement and flexibility of the spine.

Symptoms

The most visible and normal symptom of scoliosis is the curved spine. This might be noticed by an immediate relative or a close friend due to the obvious physical deformity. Patients should notice how one arm or leg is longer than the other, or when there is difficulty standing and sitting straight. Other signs include one shoulder being higher than the other, and severe back pain. Shortness of breath and chest pain also characterize this condition as the deformity of the spine affects the condition of the lungs and puts pressure on the chest cavity.

Diagnosis

A physical examination that includes the following will have to take place to correctly diagnose Scoliosis:

1. Abdominal reflexes
2. Muscle tone – this is done to test the spasticity or musculoskeletal performance of the patient.
3. Gait analysis – this is to classify the range of motion of the patients, more specifically the eye and brain as main onlooker, amplified by a set of body movements and mechanics.
4. Adams Forward Bend Test – a test instructing the patient to take off upper body clothing and bend forward. If a protrusion is present, the patient will be sent for an X-ray to verify the condition.
5. X-ray – this confirms the diagnosis if the spine forms an S-shape when looked at from the front.

Treatment

Treatments for scoliosis vary on the intensity and maturity of the condition. All types of treatment are patterned in the following order: observation, physical therapy, occupational therapy, bracing and if necessary, surgery.

Physiotherapy plays an important role in treating scoliosis, particularly the Schroth method which is used to treat scoliosis patients in Europe, North America, England, Spain and Germany. The method is a set of targeted exercises that aim to straighten the uneven, wayward curves of the spine, as well as reverse the physical effects of scoliosis. Working closely with an occupational therapist (OT) will regain the movement and strength of the spine, while a brace will provide ergonomic support and keep the spine straight and intact. Self care pain relief modalities, especially heat therapy, are recommended to help speed the recovery process because it excites the flow of oxygenated blood. 

Surgery is the last resort of treating scoliosis. It can be done by spinal fusion with instrumentation, the most common process where the bones obtained from other parts of the body or from a donor are grafted to the sides of the spine so the vertebral column will become a rigid, straight spine once it heals. There is a chance of a possible health complication after a spinal fusion due to soft tissue inflammation. A recovery process of 6-15 months with diligent physical and occupational therapy follows afterwards.