Scoliosis is defined as a side to side deviation or curvature of the spine when viewing the body from the front or back. It is normal for people to have some curvature of the spine. Mild spinal curvatures allow us to have rounded shoulders and a mild amount of swayback to our lower spine. Scoliosis is an abnormal curvature to the spine that causes the spine to both curve and twist. Scoliosis may occur at any age and in many different types of people.
Typically, other than the above mentioned congenital scoliosis and neuromuscular scoliosis, most scoliosis is called idiopathic scoliosis. About 80% of scoliosis is termed “idiopathic” which means that no cause can be found. There are 4 classifications of idiopathic scoliosis based on the age of the patient.
- Children 0-3 years old – Infantile Scoliosis
- Children 4-10 years old – Juvenile Scoliosis
- Adolescents 11-18 years old – Adolescent Scoliosis
- Patients over 18 years old – Adult Scoliosis
Curves appearing earlier in life may be more likely to progress as there is more time and growth potential prior to skeletal maturity, which may slow curve progression. Later in life, degeneration may occur in the spine due to age or unusual stresses on the spine, and previously mild and undiagnosed scoliosis may progress and become symptomatic. This is referred to as degenerative scoliosis.
Curvature may be mild to severe, and treatment is varied depending on severity and response to conservative means. Generally a mild curve of less than 10 degrees is considered spinal asymmetry not scoliosis. Curves larger than 10 degrees are often watched for progression by X-ray measurement over time. If the patient is skeletally immature as determined by the pelvic growth plate on X-ray, bracing may be helpful in controlling progression. Not all cases are candidates for bracing as this depends on the type and severity of curve. Bracing is not always considered until curves reach 20-25 degrees or show rapid progression in skeletally immature individuals. Most scoliosis is not very painful during childhood and younger adulthood, but it may cause more significant problems as people age.