Everyone’s spine has natural curves. These curves round our shoulders and make our lower back curve slightly inward. Some people have spines that also curve slightly inward. Some people have spines that also curve from side to side. Unlike poor posture, these curves cannot be corrected simply by learning to stand straight.
This condition of side-to-side spinal curves is called a scoliosis. On an X-ray, the spine of an individual with scoliosis looks more like an “S” or a “C” than a straight line. Some of the bones in a scoliotic spine also may have rotated slightly, making the person’s waist or shoulders appear uneven.
Who gets a Crooked Back?
Scoliosis affects approximately 2% of the population. If someone in a family has scoliosis, however, the likelihood of an incidence is much higher approximately 20%. If anyone in your family has curvature of the spine, you should be examined for scoliosis.
Scolioisis in Children
Most scoliosis is “idiopathic,” meaning its cause is unknown. It usually develops in middle or late childhood, before puberty, and is seen more often in girls than boys. Although scoliosis can occur in children with cerebral palsy, muscular dystrophy, spina bifida, and other miscellaneous conditions, most scoliosis is found in otherwise healthy youngsters.
Scolioisis in Adults
Scoliosis usually develops during childhood, but it also can occur in adults. Adult scoliosis may represent the progression of a condition that actually began in childhood, and was not diagnosed or treated while the person was still growing. What could have started out as a slight or moderate curve may have progressed in the absence of treatment.
Adult scoliosis can also be caused by the degenerative changes of the spine. Other spinal deformities such as kyphosis or round back are associated with the common problem of osteporosis (bone softening), As more people in Singapore reach the age of 65 years or older, the incidence of scoliosis and kyphosis is expected to increase. A sudden fall in an older person can result in a spine fracture causing sudden kyphosis. This may require urgent treatment using small needles to introduce a medication to repair the spine fracture. This can be done without open surgery as a day procedure.
If allowed to progress, severe instances of adult scoliosis can lead to chronic severe back pain, deformity, and difficulty in breathing. This may require spine surgery to correct and to prevent nerve damage.
The Importance of Early Detection – Tips for Parents
“Idiopathic scoliosis can go unnoticed in a child because it is rarely painful in the formative years.”
Therefore, parents should watch for the following warning signs of scoliosis when their child is about eight years of age:
- Uneven shoulders
- Prominent shoulder blade or shoulder blades
- Uneven waist
- Elevated hips
- Leaning to one side
Any one of these signs warrants an examination by an orthopaedic specialist.
Some schools sponsor scoliosis screenings. Although only a physician can accurately diagnose scoliosis, school screenings can help alert parents to the presence of the warning signs in their child.
Treatment for Scoliosis
In planning treatment for each child, an orthopaedic expert will carefully consider a variety of factors, including the history of scoliosis in the family, the age of the child when the curve began, and the location and severity of the curve.
Most spine curves in children with scoliosis will remain small and need only be periodically assessed for any sign of progression. If a curve does progress, physiotherapy can be done to prevent it from getting worse.
If a scoliotic curve is severe when it is first seen, surgery may be necessary. In this instance, surgery has been found to be highly effective and safe treatment for scoliosis and massage therapy or manipulations has not been shown to be effective.
Scoliosis is a common problem that usually requires only observation with repeated examination in the growing years. Early detection is important to make sure the curve does not progress. In the relatively small number of patients who require medical intervention, advances in modern spine techniques have made scoliosis a highly manageable condition.