Understanding abnormal curves

Scoliosis effect 2-4% of the population of people up to the age of 18. This figure progresses up to around 35% of the population of people 60 years of age and over suffer with this condition. In this blog we are sharing with you information about what is a scoliosis.

Normal curves Vs. normal:

A spine should be straight when observing from the front to back.  A side bend and twist in the spine of over 10 degrees, in one or more areas classifies the presence of a scoliosis. The symptoms associated with scoliosis can vary from no pain to severe pain and organ compromise. Symptoms tend to worsen with worsening of the curves.

Where can the curve be in the spine?

The side curves of a scoliosis can lie in all areas of the spine. The neck, thoracic spine (where the ribs attach to) and the low back area can all be effected. The curves can vary from 10 degrees to 50, 60 degrees and beyond.

What age group are effected?

Scoliosis can be present in all age groups, from babies to the elderly. Here are the different names given to this condition:

  • Infantile scoliosis, from birth to 3 years
  • Juvenile scoliosis, from 3 – 10 years or beginning of puberty
  • Adolescent scoliosis from 10 years to adult or full skeletal maturity
  • Adult onset scoliosis, progression from childhood or degenerative adult De Novo scoliosis from wearing of the spine, creating scoliotic deformity

What are the different types of Scoliosis?

There are numerous reasons for its formation and unfortunately, most of the cases are idiopathic, meaning, no known cause.

  1. Idiopathic (80%). No known cause for infantile, juvenile, adolescent and adult scoliosis
  2. Neuromuscular (5-7%). These conditions weaken the muscles and cause a deformity in the spine. The disorder can be in the central nervous system or in the muscles.
  3. Neurofibromatosis
  4. Congenital (10%)
  5. Traumatic
  6. Others:
  • Mesenchymal conditions, eg Marfans
  • tumours
  • metabolic
  • Rheumatoid arthritis
  • soft tissue contractures after burns
  • severe degenerative changes with osteoarthritis, etc

Early detection is important

It is during adolescence where this condition can progress rapidly and this progression is due to the rapid trunk growth that occurs during puberty. Around the ages of 9 to 13 children’s spine will develop rapidly, with girls maturing earlier than boys..  For the best outcome, early detection and treatment has been shown to minimise the risk of curve progression. 

Research: A research paper written in 2021 (1) looked at how many children with adolescent idiopathic scoliosis (AIS) sought treatment early enough to conservative bracing was effective to slow down the curve progression and avoid surgery.

The results: Most of the children presented too late for conservative brace treatment. Out the the 355 children in the study:

  • 18% had curves that were to severe to brace
  • 55% had stopped growing and they were no longer candidates for bracing
Reference
1.Anthony, A., Zeller, R., Evans, C. and Dermott, JA. (2021). Adolescent idiopathic scoliosis detection and referral trends: impact treatment options.

Lisa Smycz, chiropractor 

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