Scoliosis

Scoliosis is a curvature of the spine away from the normal accepted curves of the spine (1,2).

When the body is viewed from behind, a normal spine appears straight without much deviation from side-to-side. However if the spine is observed to have a lateral or side-to-side curvature, the person might have a condition called scoliosis. This disorder often gives the appearance of the person leaning to one side though it should not be confused with poor posture.

A layman can even help to identify a child or person with scoliosis by simply observing the person in the standing position, preferably with out a shirt and in their underpants, and observing the following (1):

1.    One shoulder may be higher than the other.
2.    One scapula (shoulder blade) may be higher or more prominent than the other.
3.    With the arms hanging loosely at the side, there may be more space between the arm and the body on one side.
4.    One hip may appear to be higher or more prominent than the other.
5.    The head is not centered over the pelvis.



When the patient is examined from the rear and asked to bend forward until the spine is horizontal, one side of the back appears higher than the other.

Once identified, the person should be sent to a health-care professional for further evaluation (1).

There are many different causes and varieties of scoliosis but by far the most common is Idiopathic scoliosis and accounts for about 85 % of all cases (1,2). "Idiopathic" means no known cause. Idiopathic scoliosis frequently runs in families and may be due to genetic or hereditary influences (3,6,7,8). However girls, for unknown reasons, are five to eight times more likely than boys to have their curves increase in size and require treatment (1,3,9).

The most frequent time for the development of Idiopathic scoliosis is during adolescence when children are completing the last major growth spurt (1,2,4). At this age young people are reluctant to allow their bodies to be seen by parents and other adults so it is important to have this age group examined on a regular basis (1).

If a scoliotic curve is found in the growing adolescent, it is very important that the curves be monitored for change by periodic examination and some times standing X-rays. In ninety percent of cases, the scoliosis are mild and do not require active treatment though increases in spinal deformity require evaluation to determine if brace or other treatment is required (4,5). In a small number of patients, surgical treatment may be needed (9).

Health-care professionals may be able to help improve spinal, joint and muscular function to help reduce symptoms associated with scoliosis (2,5,10) .


References
1. Scoliosis Australia is a project of the Spine Society of Australia, an Affiliate of the Australian Orthopaedic Association. The website provides extensive information about scoliosis. http://www.scoliosis-australia.org/index.html

2. Shakil, H; Iqbal, ZA; Al-Ghadir, AH (2014). "Scoliosis: review of types of curves, etiological theories and conservative treatment.". Journal of back and musculoskeletal rehabilitation. 27 (2): 111–5. PMID 24284269.

3. Gorman, Kristen Fay; Julien, Cédric; Moreau, Alain (14 June 2012). "The genetic epidemiology of idiopathic scoliosis". European Spine Journal. 21 (10): 1905–1919. doi:10.1007/s00586-012-2389-6. PMID 22695700.

4. Negrini, S; Minozzi, S; Bettany-Saltikov, J; Chockalingam, N; Grivas, TB; Kotwicki, T; Maruyama, T; Romano, M; Zaina, F (18 June 2015). "Braces for idiopathic scoliosis in adolescents.". The Cochrane database of systematic reviews (6): CD006850. PMID 26086959.

5. Kalichman L, Kendelkor L, Tomer B. Bracing and excercise-based treatment for idiopathic scoliosis (2016). J of Body & Mov Therapy. 20(1):56-64. DOI: http://dx.doi.org/10.1016/j.jbmt.2015.04.007

6. Ogilvie JW, Braun J, Argyle V, Nelson L, Meade M, Ward K (2006). "The search for idiopathic scoliosis genes". Spine. 31 (6): 679–681. doi:10.1097/01.brs.0000202527.25356.90. PMID 16540873.

7. Lucio Montanaro; Patrizio Parisini; Tiziana Greggi; Mario Di Silvestre; Davide Campoccia; Simona Rizzi; Carla R. Arciola (2006). "Evidence of a linkage between matrilin-1 gene (MATN1) and idiopathic scoliosis". Scoliosis. 1: 21. doi:10.1186/1748-7161-1-21. PMC 1769398. PMID 17176459.

8. Horacek O, Mazanec R, Morris CE, Kobesova A. Spinal deformities in hereditary motor and sensory neuropathy: a retrospective qualitative, quantitative, genotypical, and familial analysis of 175 patients., Spine, 2007;32(22):2502-8.

9. Downs J, Torode I, Wong K, et al (2016). The natural history of scoliosis in females with Rett Syndrome.  Spine ;41(10):856-63. doi: 10.1097/BRS.0000000000001399.