Scoliosis FAQs

What is scoliosis?

Scoliosis is a common condition where the spine curves abnormally to the side, resembling a “C” or “S” shape when viewed from the back. This curvature can occur at any part of the spine but is most commonly seen in the chest or lower back areas. Adolescent idiopathic scoliosis affects 1%-3% of US adolescents.

What are the types of scoliosis?

Scoliosis is categorized into several types:

• Idiopathic scoliosis: This is the most common type, with no known cause. It is often diagnosed in children and adolescents. 80-85% of cases are idiopathic. This type is not life threatening, and most often the curves cause no problems. Proper treatment will prevent the curve from progressing.
• Congenital scoliosis: Congenital scoliosis begins before birth. Part of the vertebrae does not form properly before birth. This type is associated with heart and kidney problems.
• Neuromuscular scoliosis: Any medical condition that affects nerves and muscles can lead to scoliosis. Neuromuscular scoliosis is linked to conditions like cerebral palsy or muscular dystrophy.
• Degenerative scoliosis: Occurs in adults due to wear and tear on the spine over time.

What are the common causes of scoliosis?

Most cases of scoliosis are classified as idiopathic, meaning the cause is unknown. However, scoliosis can also result from congenital spine deformities, neuromuscular conditions, or degenerative changes in adults. Genetic factors may also play a role in the development of scoliosis.

How is scoliosis diagnosed?

Scoliosis is usually detected during physical exams. Adolescent idiopathic scoliosis can be detected with the forward bend test. Thus, during the patient’s physical exam, Dr. Girardi will ask the patient to bend forward to check for an uneven back or shoulders. He may also use a Scoliometer to measure the curvature. Imaging tests like X-rays or MRIs are often ordered to confirm the diagnosis and measure the degree of curvature.

What are the symptoms of scoliosis?

Symptoms of scoliosis vary depending on the severity of the curve. Some people may experience no symptoms during their lives, while others might notice:

• Uneven shoulders or waist
• One hip higher than the other
• Back pain or discomfort
• Visible curvature of the spine
• In severe cases, scoliosis can lead to breathing difficulties due to reduced lung capacity.

Can scoliosis be treated?

Treatment options depend on the severity of the curve and whether it is worsening. Curve progression occurs primarily with skeletal growth during adolescence. Mild cases may not require any treatment, but regular monitoring is necessary. For moderate to severe scoliosis, options include:

• Bracing: For growing children and adolescents, bracing can prevent further curvature.
• Physical therapy: Exercises may help improve posture and reduce pain.
• Surgery: In cases where the curve is severe and progressing, spinal fusion surgery may be recommended to correct the curvature.

Treatment aims to reverse, stop or limit further spinal curvature to prevent or lessen symptoms.

Are there non-surgical treatments for scoliosis?

Yes, non-surgical treatments such as bracing, physical therapy, and pain management strategies can be effective, especially for milder cases. For those who are not candidates for surgery or who prefer to avoid it, these methods can help manage the symptoms and prevent further progression of the curvature.

Is surgery always necessary for scoliosis?

No, surgery is typically reserved for severe cases where the curve exceeds 40-50 degrees or is causing significant symptoms. Most people with scoliosis do not need surgery and can manage their condition with non-invasive treatments and regular monitoring.

What happens if scoliosis is left untreated?

In mild cases, scoliosis may not progress or cause significant problems. However, in more severe cases, untreated scoliosis can lead to worsening curvature, chronic pain, physical deformity, and in extreme cases, respiratory issues due to restricted lung capacity.

Can a child with scoliosis live a normal life?

Yes. When the curvatures does not require surgery, children can live a normal life and participate in sports and other daily activities.

Is scoliosis hereditary?

Scoliosis tends to run in families. About 30% of patients with adolescent idiopathic scoliosis have a family history of scoliosis. If a parent or sibling has scoliosis, it may increase the likelihood of developing the condition.

Can scoliosis be prevented?

There is no known way to prevent scoliosis, especially idiopathic scoliosis. However, early detection and treatment can prevent the condition from worsening and reduce the need for more invasive interventions later on.

Can scoliosis worsen over time?

Scoliosis can worsen, especially during growth spurts in children and adolescents. In adults, degenerative changes in the spine can also lead to progression. Regular check-ups are essential to monitor the condition and intervene if necessary.

Can scoliosis affect daily activities?

Mild scoliosis typically does not interfere with daily activities. However, in more severe cases, individuals may find it harder to participate in certain physical activities, and discomfort or mobility limitations can become issues.

The outlook for individuals with scoliosis varies depending on the severity and progression of the curve. With early detection and appropriate treatment, most people can live normal, active lives. Even for those who require surgery, the prognosis is generally favorable, with many experiencing significant improvements in quality of life.

Contact Dr. Girardi to schedule a consultation to learn more about your condition and discover all you treatment options. Dr. Girardi offers personalized expert orthopedic care to patients in New York, New Jersey, Connecticut and the Capital District Region, as well as international patients.

References

• https://orthoinfo.aaos.org/en/diseases–conditions/scoliosis-frequently-asked-questions/
• https://www.aafp.org/pubs/afp/issues/2020/0101/p19.html