Scoliosis

VOL 101 / NO 6 / JUNE 1997 / POSTGRADUATE MEDICINE

You can't prevent it. All you can do is watch for it. It often runs in families. Girls are four times more likely than boys to have it, and it is much more likely to progress and require treatment in girls.

What is this mystery problem?
Scoliosis is curvature of the spine to the side, with twisting (something like a corkscrew). The ribs on the side toward the curve become pushed together, and on the other side they're spread apart. Mild scoliosis is barely noticeable. But when it becomes severe, it can cause back pain, fatigue, nerve problems, disfigurement, and heart and lung problems if these organs are crowded into too little space.

How is scoliosis diagnosed?
Scoliosis usually appears in late childhood or the early teens. It can progress rapidly during the growth spurt, so about half of US states require screening beginning in fifth or sixth grade. Curvature of the vertebrae may be visible. One shoulder blade is often more prominent than the other. One shoulder or hip may be higher. The body may tilt to one side. When the person leans forward, the ribs may form a hump.

How is scoliosis treated?
Whether treatment is needed depends on the severity of the curvature, which a doctor calculates in degrees. Mild curvature rarely gets worse and needs only to be watched. Unfortunately, more severe curvature (greater than 30° or so) often does progress, even through adulthood.

A brace may prevent curves from getting worse in growing children and adolescents. It can't correct a curve, though, and it's not helpful in adults because the spine has stopped growing. Braces are made of plastic and so are lighter, more comfortable, and less obvious than they once were. But they have to be worn for at least a year and often longer.

Sometimes, a bone-fusion operation is needed. The surgeon takes slivers of bone from the pelvis and packs them between the vertebrae where the spine curves. One or two stainless steel rods are attached to the spine with hooks and wires, and the curvature is carefully corrected as much as possible. Over the course of a year or so, the bone pieces grow together and form a solid ridge that keeps the spine stable in the corrected area. Patients are in the hospital for about a week and back to most normal activities within 6 months. The rods do not have to be removed.

For more information about scoliosis and locations of meetings across the nation, contact:

National Scoliosis Foundation
5 Cabot Pl
Stoughton, MA 02072
617-341-6333
fax: 617-341-8333
e-mail: scoliosis@aol.com

This information is not a substitute for medical treatment.

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