Scoliosis

Alternative names:

kyphoscoliosis

Definition:

A lateral (away from the middle) curvature of the spine that may occur in the thoracic or lumbar segment of the spine.

Causes, incidence, and risk factors:

Scoliosis may occur by itself, or in combination with kyphosis (the condition is then called kyphoscoliosis).

Scoliosis may occur in 3 ways: as a congenital condition noticed at birth usually related to a defect in the vertebrae or fused ribs; as a paralytic or musculoskeletal disorder resulting from paralysis of the muscles due to polio, cerebral palsy, or muscular dystrophy; or idiopathic (of unknown cause) that appears in a previously straight spine.

An idiopathic disorder is the most common form and may have a genetic cause. Most cases occur in girls and become apparent during the rapid growth phase of puberty (there are infantile and juvenile forms). Scoliosis may be suspected when one shoulder appears to be higher than the other, or parents and friends may notice nothing. Routine scoliosis screening is now done in junior high school/middle school and many very early cases are detected that previously would have gone unnoticed until they were more advanced.

There may be fatigue in the spine after prolonged sitting or standing. Pain will become persistent if irritation of ligaments results. As the spine curves laterally, a compensatory curve may develop to maintain balance. The greater the initial curve of the spine, the greater the chance for progression of the condition after growth is complete. Severe scoliosis (curves in the spine greater than 60 degrees) may cause respiratory problems.