We might not think about it often, but the spine is an amazing structure. A complex arrangement of bones, disks, joints, ligaments and muscles, it allows us to stand upright, bend, twist, and navigate the world around us.
For some, especially during childhood, the spine can curve sideways in a condition known as scoliosis. This June, during Scoliosis Awareness Month, join us as we share information about scoliosis, including common types, risk factors, diagnosis, and how the specialists at North Country Orthopedic Group are here to help.
Understanding Scoliosis
Everyone’s spine is curved, depending on how you look at it. When viewed from the side, a healthy human spine has a S-shaped curve. When viewed from the front or back, however, a healthy spine should be straight.
Scoliosis is diagnosed when the spine curves from side-to-side at an angle of 10° or greater. On an x-ray, the spine of a person with scoliosis looks more like an “S” or a “C” than a straight line. Scoliosis is common, affecting between 6 and 9 million people in the United States.
There are several different forms of scoliosis, but the most common are idiopathic, neuromuscular, and congenital.
- Idiopathic scoliosis is by far the most common, accounting for 80% of all cases. It is often called adolescent idiopathic scoliosis (AIS), because it mostly affects children ages 10 through 18. Its cause is unknown, though it may be linked to genetics, since about 30% of AIS patients have a family history of scoliosis. Other potential causes, such as hormonal imbalance, asymmetric growth and muscle imbalance, have also been studied. Idiopathic scoliosis affects girls eight times as often as boys.
- Neuromuscular scoliosis is a curvature of the spine caused by an existing disorder of the brain, spinal column or muscular system. It may develop in the spine of those who can’t walk because of a condition such as muscular dystrophy, cerebral palsy or paralysis.
- Congenital scoliosis is caused by the improper formation of vertebrae while a baby is in the uterus. It is present at birth and usually diagnosed when a child is an infant. Congenital scoliosis is rare, affecting only 1 in 10,000 newborns.
Signs and Symptoms
While scoliosis can be painful for adults, it typically does not cause pain for children with mild or moderate spine curvature. For this reason, signs and symptoms of scoliosis are usually seen rather than felt. When examining your child’s body, or your own, look out for these signs:
- Uneven shoulders
- One shoulder blade that appears more prominent than the other
- An uneven waist
- One hip higher than the other
- One side of the rib cage jutting forward
- A bulge on one side of the back when bending forward
As with most medical conditions, discovering scoliosis as soon as possible is important, especially if it occurs before adolescence. Most mild cases of scoliosis require no treatment at all, but should be monitored to make sure curvature does not get worse.
Dr. Bruce Baird, Orthopedic Surgeon at NCOG
““Identifying scoliosis early, especially in children, allows us to take noninvasive measures like physical therapy for discomfort, or bracing to prevent the spine from curving further,” said Dr. Bruce Baird, orthopedic surgeon at North Country Orthopaedic Group. “These options are only effective before a child has finished growing, so regular screening for scoliosis is important. My role in the North Country is to identify which patients require only reassurance or close follow up, as well as those who would benefit from additional evaluation at a tertiary facility with a pediatric orthopedic surgeon I trust.”
Screening and Diagnosis
Since the signs of scoliosis are often visible, most cases can be identified during a routine physical exam. A scoliosis screening is usually part of a child’s well visit by age 10, when most children begin to have growth spurts. Screenings may also be offered in school by a school nurse or trained practitioner.
During a scoliosis screening, patients are observed from the front, back and side to examine their posture and look for asymmetries. Patients are also asked to bend forward and touch their toes so the screener can look for any uneven bulging of the shoulder blades or rib cage.
If signs of scoliosis are noticed during a physical exam, a follow-up X-ray or MRI may be recommended to confirm the diagnosis and determine severity.
Treatment Options
When it comes to living with scoliosis, there is good news — many patients require little, if any, treatment. Children with minor curves may only need regular checkups to ensure the curve does not worsen as they grow.
Children with moderate scoliosis who are still growing may be prescribed a plastic brace, contoured to their body, which is designed to prevent the spine’s curve from growing worse. Braces are worn for most of the day, but can be removed for sports or other activities. Once a child has finished growing, the brace is no longer used.
Physical therapy may also be recommended for moderate to severe scoliosis patients, as a way to strengthen muscles and relieve pain. A physical therapist can help with improving posture and flexibility.
In severe cases of scoliosis, surgery may be necessary when other forms of treatment have been unsuccessful. Scoliosis surgery can stabilize the spine, improve balance and relieve pain and pressure.
The Role of Orthopedic Specialists
In any scoliosis treatment scenario, having highly trained providers on your side can make all the difference. Patients in Northern New York can find peace of mind at North Country Orthopaedic Group, which has a dedicated Spine Program and several board-certified orthopedic specialists on staff.
For more than six decades, the North Country Orthopedic Group has provided local patients with treatments and therapies tailored to their individual needs. Surgeons work closely with physical therapy and rehabilitation specialists to offer patients the best available options in surgical or non-surgical treatment.
If you or a loved one has been diagnosed with scoliosis, trust the experts at North Country Orthopedic Group to guide you through the next steps. Call 315-782-1650 or visit their website to learn more and request an appointment.
