Scoliosis

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What causes scoliosis? Eighty percent of scoliosis is of unknown cause (idiopathic). Much research is being done into this field including work at the Royal Manchester Children’s Hospital. In most of these cases the condition develops in girls between 10 –15 years old and is more common in the relatives of those affected. Other cases are congenital (caused by abnormal development of the bones in the spine) and some are due to problems with nerves or muscles (such as cerebral palsy or muscular dystrophy). How is scoliosis detected? <strong>Scoliosis</strong> can be seen by a trained observer looking at a patient’s back. When a patient bends forward one side of the chest or loin may appear more prominent if scoliosis is present. Some education authorities screen all teenagers for scoliosis. If the school doctor has any doubts then an appointment is usually arranged at the scoliosis clinic for X-rays to be taken. Monitoring and progression of the curve Although some new photographic methods are now becoming available, X-rays are still the most reliable way of detecting any worsening in the degree of scoliosis. At the time of diagnosis there is no accurate way to predict which curves will worsen. Some smaller curves do not get worse. Many curves remain stable for years but suddenly get worse during the adolescent growth spurt. The child’s potential for growth is therefore one of the most important factors in predicting curve progression. In general, patients who have a lot of growth to come have a higher risk of curve progression. Growth potential, and therefore potential for curve progression, can be evaluated by age at diagnosis, menstrual history and radiological signs of bone maturity. Overall, females with scoliosis have a greater risk of curve progression. 4
Treatment <strong>Scoliosis</strong> is treated to prevent curve progression and also to preserve good appearance. There are three main types of treatment/care: • Observation • Bracing and casting • Surgery Observation Patients with a recently diagnosed mild curve are observed for a period of time to determine if the curve will progress. Since most curves do not become severe, observation is often all that is required. This enables the Surgeon to plan any active treatment that may be necessary. The most accurate method of observation is to perform a standing X-ray. Each X-ray is compared with the previous one to determine the amount of curve progression. Generally those with mild curves are seen in clinic every six months but those with larger curves will be seen every three to four months, especially if the child is growing rapidly. 5
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Scoliosis

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