What is scoliosis in children and adults
Pediatric and adolescent scoliosis is a condition in which a child’s spine bends abnormally, scoliosis can range from mild to severe.
People with mild scoliosis may need to be seen by their doctor on a regular basis. Those with more serious conditions may need braces or surgery.
Scoliosis is usually detected during development in childhood or adolescence (pediatric scoliosis). When it begins or is found after puberty, it is called “adult scoliosis” because the curve is detected after full skeletal growth.
Scoliosis is an abnormal curvature of the spine (spine). There is a natural forward and backward curve of the spine.
With scoliosis, the spine rotates and develops a curve side by side. Curves may be as mild as 10 degrees, or as severe as 100 degrees or more.
Although scoliosis itself is painless, normal age-related degeneration of the spine can lead to the appearance of symptoms.
These symptoms are treated in the same way whether there is scoliosis or not and changes in the appearance of the body are also possible depending on the degree of curvature of the spine.
In general, most scoliosis in adults occurs in the thoracic or thoracic part of the spine. In adults the main concern is usually in the lower back or lower spine.
This part of the spine is most susceptible to changes that appear with aging or degeneration.
Types of scoliosis in children and adults
There are three different types of scoliosis in children and adults:
- Idiopathic scoliosis: it is the most common type and the word “idiopathic” means that the cause is unknown, but since it runs in families, it has a genetic basis.
- Congenital scoliosis: it is a rare deformity of the spine that is detected at birth.
- Neuromuscular scoliosis: it is a curvature of the spine caused by abnormalities in the muscles and nerves that support the spine. Examples include patients with cerebral palsy, spina bifida and muscular dystrophy.
Symptoms of scoliosis in children and adults
Scoliosis usually does not cause any pain, so the symptoms can go unnoticed, but parents or medical care providers should monitor the following signs in their children:
- Uneven shoulders.
- Constant tilt to one side.
- The length of the leg is uneven.
- Prominent shoulder.
- Uneven waist.
- Raised hips.
Diagnosis of pediatric and adult scoliosis
Diagnosis of scoliosis has several steps:
- Your doctor will usually start with a comprehensive history to determine if there is a family genetic history of scoliosis. The history will also be used to detect birth defects that may explain the curvature of the spine.
- The doctor will then do a physical examination of your baby’s back, chest, pelvis, legs, feet, and skin. The doctor will be looking to see if the baby’s shoulders are level, whether the head is centered and whether the opposite sides of the body look level.
- The doctor will then ask the child to bend forward so that the back muscles can be examined, and see if one side of the rib cage is higher than the other.
- During the examination of the limbs, the doctor will assess whether the limbs are the same length. He will also check for straining of the abdominal muscles, which can cause curvature of the spine.
- After a physical examination, the doctor may order an X-ray of the spine to confirm the diagnosis of scoliosis.
The X-ray will be taken with your child standing so that the entire spine can be seen. The doctor will then measure the curves of the spine as shown on the X-ray. Curves above 25 degrees may require treatment. - If your doctor determines that your child has scoliosis, he will refer you to an orthopedic spine specialist for treatment.
Treatment of scoliosis of children and adults
Treatment of pediatric scoliosis depends on several factors:
- Type of scoliosis.
- The degree of the curve.
- Family history of scoliosis.
- The age of the child.
- How many years of growth the child has left until the skeleton matures.
If the doctor notices that the spinal curve is getting worse, he may prescribe the use of a dedicated brace to prevent it from progressing further.
If the brace does not control the curve of the spine, or if the curve is severe when the patient is first seen, surgery may be necessary.
This is usually recommended when the spinal curve is more than 45 degrees as surgery has been found to be a very effective treatment for severe scoliosis.
Treatment of scoliosis in adults
Treatment with regular monitoring
The majority of cases of scoliosis in adults can be managed non-surgically with regular monitoring by a doctor, over-the-counter pain medications, cardio strengthening exercises to strengthen the abdomen and back and improve flexibility.
In most cases, your doctor will recommend some form of physiotherapy, to maintain strength and relieve pain. These may include:
Surgical treatment
Surgery is necessary in some cases of scoliosis in adults. This treatment is the last option due to the risks of complications from spinal surgery. Surgery may be suggested for the following reasons:
- Severe pain: surgery may be needed if the back and leg pain caused by scoliosis becomes severe and persistent, and does not respond to conservative treatment.
- Spinal misalignment: whether the spine is still balanced is important in assessing the development of scoliosis and the need for surgery. When standing, the head should be balanced above the center of the pelvis when looking from the front, and above the hip joints when looking from the side. If the curve progresses to the point that this is no longer possible, patients will tend to progress over time and have more pain and disability.
- Surgery: although surgery is not recommended only to improve appearance, some people find the symptoms of spinal deformity unbearable. The imbalance in the spine also affects the basic function and the quality of life in general. Surgery is the only option in these cases. In younger adults cosmetic deformity may be a major factor in the decision to have surgery but in the elderly this is not usually the case.
Can scoliosis be prevented in adult people
Scoliosis in an adult cannot be prevented especially in cases of patients with idiopathic scoliosis, the cause of the condition is unknown.
Degenerative scoliosis occurs over time as the body ages, so it is important to regularly keep up with the program of aerobic strengthening exercises.
Non-surgical treatment, with methods such as physiotherapy, a regular exercise program, over-the-counter anti-inflammatory drugs is always the first line of care.
Maintaining an ideal body weight and maintaining a regular exercise program are excellent methods to reduce the symptoms associated with adult scoliosis.
On the other hand, surgical treatment of adult scoliosis can improve the patient’s quality of life and cope with the pain associated with the condition.
The results of surgery for spinal deformity in adults are usually very good, if performed well and for the right reasons. Nevertheless, surgical operations are associated with significant risks, and they should be avoided if possible.
