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Introduction
A healthy spine supports the body, allows you to move freely and protects the spinal cord and its bundle of nerves. It is comprised of a series of interconnecting vertebrae, joints, discs and supporting soft tissue. Between each vertebrae, the disc, or soft cushioning tissue, acts as a shock absorber when you bend or move.
Your vertebrae and discs are aligned in three natural curves. Normally, these curves are kept in balance by strong flexible muscles. When the spine also curves from side to side, the condition is called scoliosis.
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Scoliosis may develop as a single primary curve resembling the letter C, or as two curves that form an S shape. Scoliosis is often categorized as structural and nonstructural. In structural scoliosis, the spine not only curves from side to side, but the vertebrae also rotate, twisting the spine.
Scoliosis can be difficult to detect. It is usually painless and often the curvature is too subtle to be noticed. Parents should watch for the following which may be indicators of scoliosis:
- uneven shoulders
- prominent shoulder blade(s)
- uneven waist
- elevated hip
- leaning to one side
Causes
In 80% of patients, the cause of scoliosis is unknown. These cases are called idiopathic and most have a genetic basis and usually develop in middle or late childhood. It is seen in girls more often than boys. Although scoliosis can be found in children with spina bifida, muscular dystrophy and other conditions, it is usually found in otherwise healthy children.
Scoliosis can also develop in adults. This is usually a progression of an untreated childhood condition, however other factors such as posture and difference in leg length can also play a role in nonstructural (side-to-side curvature that does not twist) scoliosis.
Diagnosis
The American Academy of Orthopaedic Surgeons recommends that girls be screened twice, at age 10 and 12, and that boys be screened once at age 13 or 14. Some schools sponsor scoliosis screenings which can help alert parents to a possible condition.
Generally, only a physician can accurately diagnose scoliosis. A physician will attempt to define scoliosis by the location, direction and magnitude of the curve. Testing may include X-rays and magnetic resonance imaging (MRI).
Treatment
Scoliosis is not preventable, but early detection and treatment may limit future problems. Many curves will remain small and only require monitoring for sign of progression. If the curve progresses, an orthopaedic brace may be used to prevent further curvature.
Corrective surgery may be needed if the curve cannot be controlled by the brace, or in patients whose curve is severe.
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