Scoliosis: Causes, Diagnosis, and Treatment Options
Scoliosis is a sideways (lateral) curvature of the spine. Without timely treatment, the deformity can progress and lead to serious complications affecting breathing and quality of life.
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What is scoliosis
Scoliosis is a three-dimensional spinal deformity involving lateral deviation and vertebral rotation. It is most commonly diagnosed during adolescence (ages 10-16), though degenerative scoliosis can develop in adults due to age-related disc and joint changes.
Causes of scoliosis
- Idiopathic scoliosis, the most common form: exact cause remains unknown
- Congenital vertebral anomalies present from birth
- Neuromuscular conditions such as cerebral palsy or muscular dystrophy
- Degenerative changes in the aging spine
- Post-traumatic or post-surgical spinal imbalance
Degrees of scoliosis
Severity is measured by the Cobb angle on standing X-rays:
- Grade I: up to 10 degrees, observation only
- Grade II: 11-25 degrees, bracing recommended
- Grade III: 26-40 degrees, active treatment required
- Grade IV: over 40 degrees, surgical correction considered
In a growing child, curves exceeding 40 degrees can progress rapidly. Surgical consultation is essential to evaluate whether corrective surgery is needed before skeletal maturity.
Diagnosis
Evaluation includes a physical examination, the Adams forward bend test, and full-spine standing X-rays in two projections. MRI may be ordered to rule out spinal cord abnormalities or underlying neurological causes.
Bring any previous X-rays and MRI scans to the consultation. The curve is measured on a standing full-spine X-ray, and the treatment plan depends on that measurement, the patient's age, and how much growth remains.
Treatment options
Conservative treatment
For Grade I-II scoliosis, treatment includes therapeutic exercises, physical therapy, massage, and Cheneau-type bracing. The goal is to halt progression and strengthen the supporting muscles.
Surgical treatment
For severe scoliosis (Grade III-IV), spinal fusion with instrumentation corrects the deformity and stabilizes the spine. Modern pedicle screw systems achieve significant curve correction while preserving as much spinal mobility as possible.
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