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Overview

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. Most cases of scoliosis are mild, but some children develop spine deformities that continue to get more severe as they grow. Severe scoliosis can be disabling. An especially severe spinal curve can reduce the amount of space within the chest, making it difficult for the lungs to function properly. Others may need surgery to keep the scoliosis from worsening and to straighten severe cases of scoliosis

Why it Occurs

Doctors don’t know what causes the most common type of scoliosis — although it appears to involve hereditary factors, because the disorder tends to run in families. Less common types of scoliosis may be caused by:
• Neuromuscular conditions, such as cerebral palsy or muscular dystrophy
• Birth defects affecting the development of the bones of the spine
• Injuries to or infections of the spine

While most people with scoliosis have a mild form of the disorder, scoliosis may sometimes cause complications, including:
• Lung and heart damage. In severe scoliosis, the rib cage may press against the lungs and heart, making it more difficult to breathe and harder for the heart to pump.
• Back problems. Adults who had scoliosis as children are more likely to have chronic back pain than are people in the general population.
• Appearance. As scoliosis worsens, it can cause more noticeable changes — including unlevel shoulders, prominent ribs, uneven hips, and a shift of the waist and trunk to the side. Individuals with scoliosis often become self-conscious about their appearance.

Symptoms

Signs and symptoms of scoliosis may include:
• Uneven shoulders
• One shoulder blade that appears more prominent than the other
• Uneven waist
• One hip higher than the other
If a scoliosis curve gets worse, the spine will also rotate or twist, in addition to curving side to side. This causes the ribs on one side of the body to stick out farther than on the other side. Severe scoliosis can cause back pain and difficulty breathing.

Treatment

Scoliosis is often accompanied by slight twisting or rotation of the trunk. Scoliosis may go undetected because mild spinal curves aren’t immediately visible and the condition rarely causes pain in children. In many cases, treatment isn’t necessary, although regular follow-up is wise because spinal curves tend to worsen during periods of rapid growth. If the scoliosis causes dysfunction with breathing it may require a more aggressive treatment plan or even surgery. The two main treatments are bracing and surgery. A spinal brace slows the progression of mild- and moderate-sized growth-related curves. Surgery, which usually involves fusing some spinal bones (vertebrae) to hold them in alignment, is necessary for a severe curve to prevent continued worsening during adult life.