Scoliosis

Scoliosis is a sideways curvature of the spine, in which the spinal column can also twist, pulling the ribcage out of position. Although many people have not heard of the condition it is surprisingly common, with three to four children per 1000 needing specialist supervision. Scoliosis is not a disease. It just means that in an otherwise healthy person the spine is curved or twisted. It is not infectious or contagious and it does not develop as a result of anything the adult, child, or its parents did, or failed to do.

Scoliosis can affect people at different points in their lives. It can occur at birth (congenital), in infants (early onset), in juveniles and adolescents (late onset) and as adults (degenerative or de novo). In most cases the cause is unknown and the scoliosis is called idiopathic. In the remaining cases the causes can be attributed to neuromuscular conditions, such as muscular dystrophy or cerebral palsy, or scoliosis can result from syndromes, such as Marfan’s syndrome.

It can affect a person’s appearance because when the spine bends to the side the vertebrae (the individual bones that make up the spine) become twisted and pull the ribs round with them, which sometimes forms a characteristic lump on the back and can cause the shoulder blade to stick out. The spine can bend towards either side of the body at any place in the chest area (thoracic scoliosis), in the lower part of the back (lumbar), or above and below these areas (thoracolumbar). It can even bend twice, causing an S-shaped curve.

When the curve is S-shaped (a double curvature) it is generally not noticeable and the person can appear quite straight because the two curves counteract each other. If the curve is lower down in the spine, the ribs will not be affected but one hip might be higher than the other. The causes of scoliosis are many, and although we well understand the consequences, the origins of this condition remain complex and obscure.

There is contradictory evidence as to whether early discovery and treatment of a curve improves the long-term outcome, but we know that if curves are discovered late, when they are already severe, the results of treatment can be compromised. Therefore it is important that early referral to a scoliosis specialist is achieved. Treatment in a scoliosis centre will usually prevent unsatisfactory long-term results.