What is scoliosis of the spine?

Scoliosis is a sideways curvature of the spine. Scoliosis is a sideways curvature of the spine that occurs most often during the growth spurt just before puberty. While scoliosis can be caused by conditions such as cerebral palsy and muscular dystrophy, the cause of most scoliosis is unknown. Physiotherapy Now

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Dr. Maziar Badii, MD, FRCP, Rheumatologist, discusses diagnosis of congenital scoliosis.

Quiz: Do You Understand Scoliosis?

Test your knowledge by answering the following questions:

Questions
True
False
1

Scoliosis is equally common in children and adults.

Explanation:
There are several types of scoliosis, and it occurs most often in children between 9 and 15 years of age.
2

Congenital scoliosis is more common than acquired scoliosis.

Explanation:
Typically, scoliosis is classified as congenital, meaning there were vertebral deformities or anomalies present at birth, or acquired. Congenital scoliosis accounts for about 15 to 20 percent of all cases, while acquired accounts for 80 to 85 percent of cases.
3

A shoulder blade that’s more prominent than the other can be a sign of scoliosis.

Explanation:
Scoliosis symptoms include one shoulder blade that’s more prominent than the other and uneven shoulders, waist or hips.
4

Wearing a brace will cure scoliosis.

Explanation:
In many cases, scoliosis treatment isn’t required. Some children will need to wear a scoliosis brace to keep the curve of the spine from getting worse. Wearing a brace won't cure scoliosis, but it usually prevents further progression of the curve. Most patients who wear scoliosis braces keep them on day and night, and stop wearing them after the bones stop growing.
5

The most common type of scoliosis surgery is called spinal fusion.

Explanation:
The most common type of scoliosis surgery is called spinal fusion, in which surgeons connect two or more of the bones in the spine (vertebrae) together. Then, bone or a bone-like material is placed between the vertebrae and held in place by metal rods, screws, wires or hooks.
(Answer all questions to activate)

Dr. Maziar Badii, MD, FRCP, Rheumatologist, discusses The Symptoms of Scoliosis

Long Term Management of Scoliosis

It’s in two settings. For adolescents, it’s important to have it diagnosed because if it’s the ones that progress and the ones that you can prevent through simple treatments, either with bracing or in more rare cases, orthopedic surgery, it can have a profound impact later on in life, in both cosmetic appearance of that person, and also in terms of function, heart or lung ability to expand, participation in sports.

If the curvature is so much that it’s putting pressure on nerves and causing weakness or neurological symptoms, in arms or legs, these, in those cases that need to be treated, can be prevented by diagnosis and follow-up.

In the case of the adult onset scoliosis, it’s important because it could potentially be a serious condition, be it a tumor or a mass or a neurological problem that has brought this on.

And so if it’s not diagnosed, it could even be potentially life threatening or put a patient at risk of serious injury or long-lasting effect. So even though scoliosis is extremely common, even though the vast, vast majority, with proper diagnosis by an expert, don’t need any treatment, don’t need any investigation, there are ones that do need investigation, and do need specific treatment in the right setting, so it’s important to see someone who is specializing or comfortable with treating this condition.

If you think you have a scoliosis, either because you’ve seen asymmetry of your posture yourself, or of someone has commented that you may have an abnormal curve in your spine, see your family physician. They can examine you and answer your questions.

You might visit a rheumatologist for information on what is, conditions, side effects, symptoms and treatments related to scoliosis diagnosis, spinal disorders and genetic conditions in adults and children.

Presenter: Dr. Maziar Badii, Rheumatologist, Vancouver, BC

Local Practitioners: Rheumatologist

Diagnosis of Congenital Scoliosis

Fifteen to twenty percent of scoliosis is congenital, so people are born having a scoliosis.

Now these are often diagnosed by the pediatrician that examines the baby in the delivery room, finds that there is a curvature that looks scoliotic. Interestingly, the scoliosis itself probably occurs as early as somewhere between the second to the seventh week in utero.

So the spine, when it starts to segment itself, it can be problems with segmentation, so some levels don’t divide. Or one half of the spine grows faster or doesn’t grow at all, turning this straight line into a curve. And so sometimes the scoliosis is even picked up by in-utero testing, for example, an ultrasound may be able to identify this.

The other 80 percent are cases where at birth, there is no scoliosis. It comes on. The most common form is the idiopathic, cause is not known. It can happen during infancy. It can happen during childhood.

The most common form is as an adolescent, so somewhere between ages of 11, to 15, 16. Typically, girls reach skeletal maturity, meaning they stop growing when they are 16 or so. Boys go a bit longer. They grow until 20 or 21, when they reach skeletal maturity.

After that, the skeleton doesn’t grow, so scoliosis doesn’t progress, unless there is a secondary cause, be it injury, or be it a mass in the spine or a neurological damage, those are the acquired forms.

Speaking about the idiopathic scoliosis, the ones that are the most common, the ones that are diagnosed in teenage years, they’re often done by a family physician, or sometimes by a school therapist or a phys ed teacher. They see the scoliosis, they send them to the family physician.

Often, the family physician asks for a scoliosis specific X-ray film, a film that covers the thoracic spine and the lumbar spine, with the person standing. It can be done in different planes.

The important thing when it comes to idiopathic scoliosis, is to do serial examination. This will be done by your doctor, but you can keep an eye on it yourself as well. The idea is that a scoliosis that is fairly stable is not going to increase in curve over time, so it doesn’t need any specific treatment. It can be observed.

But a scoliosis that keeps increasing over time, both looking at it, and on X-ray, is something that will potentially need more attention because it may potentially be associated with symptoms.

If you think you have a scoliosis, either because you’ve seen asymmetry of your posture yourself, or if someone has commented that you may have an abnormal curve in your spine, see your family physician. They can examine you and answer your questions.

You might visit a rheumatologist for information on what is, conditions, side effects, symptoms and treatments related to congenital scoliosis, idiopathic scoliosis, and other spinal conditions. Local Physiotherapist.

Presenter: Dr. Maziar Badii, Rheumatologist, Vancouver, BC

Local Practitioners: Rheumatologist

Dr. Maziar Badii, MD, FRCP, Rheumatologist, discusses treatment & prognosis of scoliosis.

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