Scoliosis is the sideways curvature of the spine that usually occurs during the growth spurt before a person reaches puberty. This results in a spinal deformity that worsens as the child grows.
Although cerebral palsy and muscular dystrophy are known to cause scoliosis, the definitive cause in most of the cases is still unknown. According to the statistics, around 3% of the world’s adolescents are diagnosed with scoliosis.
Most people have mild scoliosis that can be managed. The severe form of the defect can cause disabilities with severe bending of the spine, reduction in the size of the chest cavity. It may also lead to insufficient lung capacity.
Causes and Risk factors
Although studies have not given definitive causes behind scoliosis, some likely causes are reported to be –
- Injury or an infection in the spine
- Musculoskeletal diseases such as Cerebral Palsy and Muscular Dystrophy
- Birth defects that cause spinal curving
Risk factors associated with Scoliosis are –
- Age – the majority of the scoliosis cases tend to develop around puberty
- Gender – females are more prone to developing scoliosis
- Family history – scoliosis is a hereditary trait and can be passed on from one generation to other.
The symptoms for scoliosis include –
- Uneven shoulders – one shoulder blade more prominent than the other
- Uneven wrists
- Uneven waist or one hip higher than the other
In severe cases, the spine may also twist or rotate, causing the rib cage on one side to be more prominent than on the other side.
Types of scoliosis
There are different types of scoliosis and the most common way to differentiate between them is on the basis of the underlying cause of the disease. The three basic types in which scoliosis can be categorized are –
Idiopathic Scoliosis means that the cause behind the disease is unknown, and no single factor can be attributed to the disease.
Congenital Scoliosis is the one that is diagnosed at birth itself, hence they are diagnosed at a very early stage.
Neuromuscular Scoliosis develops secondary to another neurological or muscular problem, such as Muscular Dystrophy or Cerebral Palsy. This type of scoliosis tends to progress at a much faster rate than the others.
The different types of scoliosis in details –
- Congenital Scoliosis
Congenital scoliosis is very rare, and only 1 in 10,000 newborns are diagnosed with it. This usually develops as a spinal abnormality in the womb. During fetal development, the malformation of the spine leads to scoliosis. This can further progress into partial formation/absence of some spinal bones, resulting in a sideways curvature of the spine.
As this disease starts to develop in the primitive years of life, congenital scoliosis can usually be detected at a very early age. Symptoms might include – tilted shoulders, uneven waistline, sideways curvature of the spine and protruding rib cage from one side.
- Adolescent Scoliosis
This is the most common type of scoliosis. If the scoliosis is diagnosed before the age of 10, it is called early-onset scoliosis. One needs to determine the age at which scoliosis affects a child, it can be before 10 years of age, or after that. The reason for this is that in a child above the age of 10, most of the spinal growth has already occurred. The cases of scoliosis which present before the age of 10 can thus cause a deformity in the rib cage and other bone malformations.
Adolescent idiopathic scoliosis
This is the most common type of scoliosis that is diagnosed in children between the age of 10 to 18 years. The exact cause behind this is not known, but studies suggest it can possibly occur due to hormonal imbalances or asymmetric growths. It is estimated that 4 out of 10 children are diagnosed with this type of scoliosis. About 30% of adolescent idiopathic scoliosis have a family member with the same problem. Most patients appear relatively normal when viewed from one side. Other symptoms include uneven shoulders, protruding rib cage on one side and uneven waist.
- Degenerative scoliosis
It is also called as Adult-onset scoliosis or De Novo scoliosis. It presents with a slow-growing curve in the lower back (lumbar spine) that takes a C-shape. This type of scoliosis takes time to develop, and studies suggest that it is not linked to family history. It is generally caused by age-related spinal degeneration that results in spinal curvature. A recent study has suggested that over 60% of the adult population over the age of 60 develop some degree of degenerative scoliosis in their spine.
- Neuromuscular scoliosis
This develops secondary to various disorders of the brain, spinal cord or other muscular tissues. This is the most idiopathic type of scoliosis. Spinal curvatures occur when the nerves are unable to maintain the balance of the spinal cord, and these curvatures are then carried forward to adulthood with a gradual increase in the degree of the deformity. Some possible disorders leading to such types of scoliosis are myelodysplasia, cerebral palsy, Duchenne muscular dystrophy, Freidrich ataxia, and spinal muscular atrophy.
- Scheuermann’s Kyphosis
While scoliosis is diagnosed by viewing the spine from the front, kyphosis is the forward bending of the spine. It most often affects the lower spine and usually results from some structural deformity of the spine. The symptoms include poor posture, back pain, and stiffness in the back. These symptoms don’t usually worsen, limiting the severity of the disease.
- Syndromic scoliosis
As the name suggests, this type of scoliosis results secondary to some syndrome. They can be Rett’s syndrome, Beale’s syndrome, muscular dystrophy, osteochondrodystrophy, and some connective tissue disorders. As different syndromes present with different symptoms, this scoliosis also presents with varied symptoms. It can affect children of any age.
Scoliosis surgery cost varies on multiple factors – such as age, gender, the severity of the disease and type of scoliosis diagnosed. Most mild cases of scoliosis do not need any surgery and follow-ups every 4 to 6 months can help manage the disease.
The common treatment options include
- Casting – Typically used in infantile cases of scoliosis, where a slight curvature is noted. Plaster of Paris is used to fabricate casts that help align the spine.
- Braces – there are 2 types of braces available.
The type of brace used for every patient differs. The basic aim of a brace is to put pressure on the curved spine by forcing the back to have a corrected posture. How much does scoliosis surgery cost will depend on the type of brace used –
- Thoracolumbosacral orthosis (TLSO)
- Milwaukee brace
- Chiropractic Treatment