Scoliosis

What is scoliosis?

Scoliosis is a deformity of the spine, where it is bent laterally (from side to side) into an S or C shape. (Normally, the spine goes straight up although it does follow a natural front-to-back curve.) Occasionally, there's also a horizontal twist or rotation of the spine.

Symptoms

Scoliosis often starts at about the age of eight but may go unnoticed, especially as it rarely causes problems in the early years. Parents may see an uneven waist or shoulders, particularly prominent shoulder blades, elevated hips or leaning to one side.

As scoliosis progresses it may cause back, limb or abdominal pain and may start to restrict breathing as lung cavity is distorted.

Causes and risk factors

Idiopathic scoliosis (meaning the cause is unknown) is the most common cause. It can be either early onset (less than 5) or late-onset (accounting for about 85% of cases) which usually affects healthy girls between the ages of ten and 14, during the growth spurt of puberty.

Congenital scoliosis is when a child is born with scoliosis, for example, because they have a vertebra that is not formed properly.

In a number of cases, scoliosis forms secondary to a different condition, particularly those that cause an imbalance in the muscles, such as muscular dystrophy or cerebral palsy.

It may also follow problems with the bones or connective tissues, such as neurofibromatosis or Marfan syndrome.

Overall, about two per cent of the population have scoliosis. However, it does run in families and in an affected family about 20 per cent may have the condition.

Treatment and recovery

Diagnosis should be made by a doctor after a thorough medical examination. The child's back should be examined when they're bent forward (scoliosis caused by bad posture will straighten). Treatable causes should be ruled out. An x-ray of the spine will confirm the diagnosis.

Treatment consists of observation, bracing and surgery. If the curvature isn't severe or the child has nearly finished growing, they may simply be checked on a regular basis. Most will get better without treatment.

However, a brace is sometimes necessary to prevent scoliosis getting worse, and must be fitted by a specialist. In severe cases, especially if the child is still growing, surgery may be necessary to straighten the spine.

A special programme of exercises is recommended by some as a non-invasive way to improve posture and function. However, these involve a very intensive and expensive course of training, and there is, as yet, no convincing scientific evidence to prove that there are any long lasting effects or that the exercises prevent the need for surgery.

Scoliosis can get worse in adult life, causing problems with back pain and increasingly obstructing normal breathing. Talk to your doctor if you're worried.

Advice and support

• Scoliosis Association (UK)
• Helpline: 020 8964 1166
• Email: sauk@sauk.org.uk
• Website: www.sauk.org.uk

• Strongbones Children's Charitable Trust
• Tel: 020 8590 6688
• Email: administration@strongbones.org.uk
• Website: www.strongbones.org.uk