Scoliosis
Scoliosis is a condition in which the spine curves abnormally to one side — in a C- or S-shaped pattern when viewed from behind — rather than running in a straight vertical line. It is not simply a postural habit but a structural three-dimensional deformity that involves lateral curvature, rotation of the vertebrae, and changes in the normal front-to-back curves of the spine. It affects people of all ages, though it most commonly develops during the adolescent growth spurt.
Types and causes
The most common type — adolescent idiopathic scoliosis — accounts for approximately 80% of cases and, as the name suggests, has no identifiable cause. It affects girls more frequently than boys and tends to progress most rapidly during periods of rapid growth. Congenital scoliosis results from abnormal vertebral development in the womb (such as hemivertebrae or fused ribs). Neuromuscular scoliosis develops secondary to conditions affecting muscle tone and control, including cerebral palsy, muscular dystrophy, and spinal muscular atrophy. Degenerative (adult) scoliosis develops in older adults as a result of asymmetric wear and degeneration of the spinal discs and joints.
Symptoms
Mild scoliosis is often detected incidentally — by a parent, school nurse, or during a routine examination — before any symptoms develop. Visible signs include uneven shoulder height, a prominent shoulder blade, an asymmetrical waistline, and — the most reliable early sign — a rib hump or paraspinal prominence visible when the patient bends forward (the Adams forward bend test). In more severe curves or adult degenerative scoliosis, back pain, fatigue, and in very severe cases, impairment of cardiac and pulmonary function due to thoracic cage distortion may occur.
Diagnosis and monitoring
Full-length standing spinal X-rays allow measurement of the Cobb angle — the standard measure of curve severity. Curves below 10° are considered within normal variation; curves between 10–25° are mild, 25–45° moderate, and above 45° severe. In growing children, the risk of progression is assessed using skeletal maturity markers.
Choosing where to be treated
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