What is scoliosis?

 

 

 

 

 

 

 

 

 

 

 

 

 

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.  Most cases of scoliosis should be monitored by a scoliosis specialist (it is crucial that people with the disorder see a specialist.

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.

 

 

Definitions

 

 

 

 

 

 

 

 

Cervical:

in scoliosis cervical refers to the seven cervical vertebrae that make up the top part of the spine.

 

Cobb angle:

This is the name of the measurement of scoliosis that is obtained from an X-ray.  It refers to the severity of the curvature and is measured in degrees.  A measurement under 10 degrees is regarded as normal, between 10 degrees and 30 degrees is classed as mild, and anything over 60 degrees is severe.

 

Congenital:

This refers to a condition that is present at birth, such as a malformed vertebra.

 

Costoplasty (Costectomy):

This is a ‘cosmetic’ operation, in which part of the rib cage that is prominent is removed to improve appearance.

 

Degenerative:

Sometimes called neurodegenerative, this refers to a disease or condition that results in progressive deterioration and is usually age-related– it continues to get ‘worse’ over time.

 

Early-onset scoliosis:

An idiopathic scoliosis developing before the age of 7 years.

 

Idiopathic:

This means that the cause (of a disease/condition) is unknown. Idiopathic scoliosis means that the curve has formed for an unknown reason.

 

Kyphosis:

This is the term given to an “outward” curve of the upper part of the spine that makes the back appear more rounded than usual, and can cause stiffness or back pain.

 

Kyphoscoliosis:

When both kyphosis and scoliosis are present.

 

Late-onset scoliosis:

An idiopathic scoliosis developing after the age of 7 years.

 

Lordosis:

This is the term given to an inward curve of the middle and lower part of the spine that makes the back appear 'C' shaped.  It is sometimes referred to as sway back or saddle back.

 

Lumbar:

The lumbar region is the lower part of the spine and is made up of five vertebrae. It is the strongest part of the spine and bears a lot of weight.

 

Marfan’s syndrome:

Cause unknown but symptoms can include the following: dislocation of the lens of the eye; arachnodactyly (very long fingers and toes): high arched palate; unusually stretchable ligaments; foot problems; abnormalities of the heart; scoliosis. Note: not all these symptoms are necessarily present in the same patient and some times the condition remains mild.

 

Neurofibromatosis: A disease which produces many coffee-coloured skin patches, and sometimes lumpy nodules of the nerve and fibrous tissue. It can sometimes cause scoliosis and may produce a characteristically sharp edged curve.

 

Neurological system:

Also known as the nervous system, the neurological system is the tissues, cells, and organs that regulate the body’s response to internal and external stimuli or events.

 

Osteoporosis:

This is condition  resulting in a decrease in bone density that causes bones to become weak or fragile.

 

Prognosis:

This is a medical term which means ‘the likely outcome or course of a disease’ –  ie, a prediction of what will happen to the patient as a result of the disease/condition, such as the likelihood of recovery.

 

Pulmonary function:

This refers to the function of the lungs.  How well they are working can be measured by specific tests.

 

Rett Syndrome:

Rett syndrome is a rare neurological disorder affecting mainly girls and women and very few boys and men. People with Rett syndrome have profound and multiple physical and learning disabilities and are totally reliant on others for support throughout their lives. Although present at birth, it is usually undetected until major regression occurs at around 1 year of age, when children will lose acquired skills - this can be accompanied by distress and anxiety.

 

Rib prominence:

With scoliosis there is a rotation (twisting) of the vertebrae; since the ribs are attached to the vertebrae, this causes a rib prominence in the back on the side of the curvature (convexity) and rib depression on the opposite side (concavity).

 

Scheuermann's disease/kyphosis:

Scheuermann's disease describes a condition where the vertebrae grow unevenly in childhood. This uneven growth results the signature wedging shape of the vertebrae, causing kyphosis. It is also known as Scheuermann's kyphosis.

 

Scoliosis:

Sideways curvature of the spine.

 

Spinal fusion:

Surgical operation to stabilise the spine by taking away movement in the vertebrae involved in the spinal curvature.

 

Symptomatic:

Showing symptoms as a result of a disease/condition. Symptoms are signs of the disease/condition that are usually noticed by the patient, or, more often in the case of scoliosis, someone close to the patient.

 

Syndromic:

Relating to a syndrome. Syndromic scoliosis means that scoliosis has occurred secondary to a syndromic disorder, such as Marfan’s syndrome.

 

Thoracic:

Thoracic refers to the twelve vertebrae between the cervical and lumbar parts of the spine. The thoracic vertebrae are attached to the ribs, and the chest is often referred to as the thoracic cavity. In terms of scoliosis, a thoracic curve is a ‘C’ shaped curve of the upper back.

 

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Scoliosis Foundation (Ghana). is a Patient-Led-Non profit Organization. With Charitable Registration Number: CG 156312015 | Registration Of  NGO (AMA): A 026/10/28