Scoliosis Fitness

What is Scoliosis?

Scoliosis is defined as an abnormal lateral curvature of the spine per the American Association of Neurological Surgeons. The spine has natural curves. These curves separate the spine into three sections: Lumbar (Low Back), Thoracic (Mid and Upper Back) and Cervical (Neck). While these natural curve occur along the center line of the body, curving towards the front and back of the body; Scoliosis occurs when the spine curves unnaturally off to the side. This can be a "C" curve (one side) or an "S" curve (both sides). 

The body is details through three anatomical planes. Coronal, Sagittal and Axial. 

The Coronal Plane is the plane when viewing the body from the front or back. It separates the body into the Posterior (rear) and Anterior (front). The is the plane that a Scoliotic curve is measured on.

The Sagittal Plane the the plane when viewing the body from the side. It separates the body into the left and right sides and the centerline of the plane creates orientation of the lateral (towards the outside of the body) and the medial (towards the centerline of the body) directions.

The Axial Plane is the plane when viewing the body from the top or bottom. It separates the body into the Superior (upper body) and Inferior (lower body).

While a Scoliotic curve is measured on the Coronal plane, in reality, most scoliotic curves have a rotational component as well. This means that curves are not just perfectly left or right, they actually exist in three dimensions. This is important to keep in mind as every curve is different which means treatment will be different for everyone. 

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Causes of Scoliosis

There are several types of scoliosis, and the causes may vary depending on the type:


  • Idiopathic scoliosis: This is the most common form of scoliosis, and its cause is unknown. It is further classified as infantile, juvenile, or adolescent, depending on the age of onset.

  • Congenital scoliosis: This type occurs when the spine does not form properly during fetal development.

  • Neuromuscular scoliosis: This form is associated with neurological or muscular disorders, such as cerebral palsy or muscular dystrophy.

  • Degenerative scoliosis: This type occurs in adults and is often caused by the degeneration of the spinal discs or joints due to aging or injury.

Symptoms and Diagnosis

Some common signs and symptoms of scoliosis may include:


  • Uneven shoulders, hips, or waist

  • Prominent shoulder blade(s)

  • A visible curve in the spine

  • Back pain or discomfort (more common in adults)


To diagnose scoliosis, a healthcare professional will perform a physical examination and may order imaging studies, such as X-rays, to assess the severity and type of the curve.

Detection

Early detection of scoliosis is crucial for effective management and treatment. This section will provide an overview of the various tests and screenings used to identify scoliosis, as well as the diagnostic process.

Initial Screening

Scoliosis screening is typically performed during routine physical examinations, especially for children and adolescents, as this is when scoliosis is most commonly diagnosed. Some common screening tests include:


  1. Adams Forward Bend Test: The individual is asked to bend forward at the waist with arms hanging and palms touching each other, while the healthcare professional observes the spine and ribcage for any asymmetry or humps, which may indicate scoliosis.


  1. Postural Assessment: The healthcare professional checks for signs of scoliosis by examining the individual's posture, looking for uneven shoulders, a prominent shoulder blade, or an uneven waistline.


Diagnostic Tests

If scoliosis is suspected during the initial screening, the healthcare professional may order additional tests to confirm the diagnosis and determine the severity of the condition:


  1. X-rays: X-ray images of the spine provide a detailed view of the bones, allowing the healthcare professional to evaluate the degree of the spinal curve using the Cobb angle. X-rays are also used to monitor the progression of the curve over time.


  1. Magnetic Resonance Imaging (MRI): In some cases, an MRI may be ordered to assess the spinal cord and surrounding structures, particularly if there are concerns about underlying conditions or neurological symptoms.


  1. Computerized Tomography (CT) Scan: A CT scan may be used to obtain a more detailed view of the spine in certain situations, such as when planning for surgery.


Factors Affecting Diagnosis

Several factors play a role in the diagnosis and classification of scoliosis:


  • Type of scoliosis: Determining the type of scoliosis (idiopathic, congenital, neuromuscular, or degenerative) can provide insight into the potential cause and guide treatment options.

  • Age of onset: The age at which scoliosis is diagnosed can impact the likelihood of curve progression and the recommended course of treatment.

  • Curve severity and location: The degree and location of the spinal curve help determine the appropriate treatment approach and potential risks associated with the condition.


Testing for scoliosis involves an initial screening during routine physical examinations, followed by diagnostic tests if scoliosis is suspected. Early detection is crucial for effective management and treatment. If you or a loved one is experiencing signs of scoliosis, consult a healthcare professional for a thorough evaluation and appropriate guidance.

Severity

The severity of scoliosis is determined by the degree of the spinal curve, which is measured in degrees using a technique called the Cobb angle. This section will help you understand the different degrees of curve severity, how they are measured, and the potential implications for treatment and management.

Cobb Angle

The Cobb angle is a standard method for assessing the severity of scoliosis. It is measured using X-rays of the spine and involves drawing lines parallel to the top and bottom vertebrae of the curve. The angle between these lines represents the degree of the spinal curve. Healthcare professionals use the Cobb angle to monitor the progression of scoliosis and determine the appropriate treatment approach.

Based on the Cobb angle, scoliosis curves can be categorized into the following degrees of severity:

  1. Mild scoliosis (10-25 degrees): A curve in this range is considered mild and may not require aggressive treatment. Regular monitoring and check-ups are typically recommended to ensure the curve does not progress.


  1. Moderate scoliosis (26-40 degrees): A moderate curve may warrant closer monitoring and could necessitate intervention, such as bracing, to prevent further progression, particularly in growing children.


  1. Severe scoliosis (41 degrees and above): Severe curves can have a significant impact on the individual's overall health and quality of life.


Treatment Options

The treatment for scoliosis depends on the severity of the curve, the patient's age, and the underlying cause. Some common treatment options include:


  • Observation: For mild curves, doctors may recommend regular check-ups to monitor the progression of the curve.

  • Bracing: For moderate curves, a brace may be prescribed to help prevent the curve from worsening, particularly in growing children.

  • Physical therapy: Specific exercises and stretches can help improve posture, strengthen muscles, and alleviate pain.

  • Surgery: In severe cases, surgery may be recommended to correct the curve and stabilize the spine.

Conclusion

Scoliosis is a complex condition that affects individuals differently. Early detection and appropriate treatment are crucial in managing the condition and preventing complications. If you suspect you or someone you know has scoliosis, consult a healthcare professional for a proper evaluation and guidance on the best course of action.