Scoliosis is a sideways curvature of the spine. Scoliosis is a sideways curvature of the spine that occurs most often during the growth spurt just before puberty. While scoliosis can be caused by conditions such as cerebral palsy and muscular dystrophy, the cause of most scoliosis is unknown.

he word scoliosis comes from Greek, scolios, meaning curved or crooked.Scoliosis implies and abnormal curvature of the spine, so the human spine has three normal curvatures, so just looking at you like this, my neck is curved inside. That’s a lordosis.

Then the thoracic spine is curved back. That’s a kyphosis. And then it’s curved inwards again, another lordosis. That’s a front-to-back curve. A scoliosis is talking about the curve in this plane, so going this way. Now if we were to take a picture of someone with a scoliosis, and looked at it on a two-dimensional plane, like on a plane X-ray, it would look either like a C, so one curve, or an S. That is an abnormal curvature in this plane, or a scoliosis.                    

Typically, scoliosis is classified as either congenital, meaning there were vertebral deformities or anomalies present at birth, or acquired. So it happened after birth. The congenital accounts for about 15 to 20 percent of all cases. And the acquired is 80 to 85 percent of all cases. In the acquired group, the majority of cases are idiopathic, so around 70 percent or more are idiopathic, meaning cause is not known. The other 30 percent have a cause known, usually either a neuromuscular problem or a structural problem relating to the vertebrae or the discs, usually as a process of aging or degenerative changes, in the latter group.

Of the acquired forms of the scoliosis, the most common one is the idiopathic, cause unknown. The idiopathic scoliosis is classified as to when it first appeared, so it’s classified as infantile, juvenile, adolescent or adult. By far, the commonest one is the adolescent idiopathic scoliosis. Local Physiotherapist

If you think you have a scoliosis, see your family physician. They will ask you some questions. They will examine your back. The doctor may decide that you don’t need an x-ray or any further imaging, or your doctor may decide that you need further workup and a treatment plan. Local Orthopedic Surgeon

You might visit a rheumatologist for information on what is, conditions, side effects, symptoms and treatments related to scoliosis, joint pain, and other spinal conditions. 

Presenter: Dr. Maziar Badii, Rheumatologist, Vancouver, BC

Local Practitioners: Rheumatologist

Fifteen to twenty percent of scoliosis is congenital, so people are born having a scoliosis. Now these are often diagnosed by the pediatrician that examines the baby in the delivery room, finds that there is a curvature that looks scoliotic. Interestingly, the scoliosis itself probably occurs as early as somewhere between the second to the seventh week in utero.

                         

So the spine, when it starts to segment itself, it can be problems with segmentation, so some levels don’t divide. Or one half of the spine grows faster or doesn't grow at all, turning this straight line into a curve. And so sometimes the scoliosis is even picked up by in-utero testing, for example, an ultrasound may be able to identify this.

The other 80 percent are cases where at birth, there is no scoliosis. It comes on. The most common form is the idiopathic, cause is not known. It can happen during infancy. It can happen during childhood.

The most common form is as an adolescent, so somewhere between ages of 11, to 15, 16. Typically, girls reach skeletal maturity, meaning they stop growing when they are 16 or so. Boys go a bit longer. They grow until 20 or 21, when they reach skeletal maturity.

After that, the skeleton doesn't grow, so scoliosis doesn't progress, unless there is a secondary cause, be it injury, or be it a mass in the spine or a neurological damage, those are the acquired forms.

Speaking about the idiopathic scoliosis, the ones that are the most common, the ones that are diagnosed in teenage years, they’re often done by a family physician, or sometimes by a school therapist or a phys ed teacher. They see the scoliosis, they send them to the family physician.

Often, the family physician asks for a scoliosis specific X-ray film, a film that covers the thoracic spine and the lumbar spine, with the person standing. It can be done in different planes.

The important thing when it comes to idiopathic scoliosis, is to do serial examination. This will be done by your doctor, but you can keep an eye on it yourself as well. The idea is that a scoliosis that is fairly stable is not going to increase in curve over time, so it doesn't need any specific treatment. It can be observed.

But a scoliosis that keeps increasing over time, both looking at it, and on X-ray, is something that will potentially need more attention because it may potentially be associated with symptoms.

If you think you have a scoliosis, either because you’ve seen asymmetry of your posture yourself, or if someone has commented that you may have an abnormal curve in your spine, see your family physician. They can examine you and answer your questions.

You might visit a rheumatologist for information on what is, conditions, side effects, symptoms and treatments related to congenital scoliosis, idiopathic scoliosis, and other spinal conditions.   Often seeing a local family physician or a physiotherapist in conjunction with a registered dietitian and athletic therapist is a great option to take control of this condition. Smart Food Now and exercise is also optominal for overall health.    

Presenter: Dr. Maziar Badii, Rheumatologist, Vancouver, BC

Now Health Network  Local Practitioners: Rheumatologist