What is scoliosis?
Scoliosis is a problem that causes your spine to deviate from its ‘normal’ alignment. Scoliosis has been described as more of a physical condition than a diagnosis. Either way it results in a structural deformity. The deformity can have up to four components. The most obvious deformity is lateral curvature. The universal method of measurement of lateral deformity is the “Cobb angle”, which measures the degree of lateral curve created by the scoliosis. Secondly there is rotational deformity. As the spine deviates laterally it usually rotates. This rotation is what causes the “humps” that are evident when you bend forward. Thirdly there is “decompensation”. This relates to the head not being balanced perfectly over the hips. With most scoliosis, there is a tendency to be “decompensated” to the left. I.e. your head is slightly left of the center of your pelvis. Fourth there can be reduced “kyphosis” otherwise known as “flat-back”, particularly prevalent with thoracic scoliosis.
What Causes Scoliosis?
In 80 to 85 percent of people, the cause of scoliosis is unknown; this is called idiopathic scoliosis. Before concluding that a person has idiopathic scoliosis, the doctor looks for other possible causes, such as injury or infection. While many theories have been expressed as to the possible cause of idiopathic scoliosis, the actual cause remains unknown. It is known that there is a genetic prevalence, meaning that a sibling or child of someone with scoliosis has an increased risk of getting it.
Who Gets Scoliosis?
People of all ages can have scoliosis, but is most prevalent amongst adolescent children. Of every 1,000 children, 3 to 5 develop spinal curves that are considered large enough to need treatment. Adolescent idiopathic scoliosis occurs after the age of 10. Girls are more likely than boys to have this type of scoliosis. Idiopathic scoliosis can also occur in children younger than 10 years of age, but is more rare. Early onset or infantile idiopathic scoliosis occurs in children less than 3 years old. It is more common in Europe than in the United States. Juvenile idiopathic scoliosis occurs in children between the ages of 3 and 10.
Why Treat Scoliosis?
A significant scoliosis that is untreated can get worse as you grow and could cause problems in later life. As a scoliosis develops your body will show more and more signs of the scoliosis. You will usually begin to lose your waist line and will likely develop a rib hump on your back. If the scoliosis develops too far, you will need to have a big surgery to correct your spine that will also reduce your spinal flexibility. There are no specific indicators that determine whether or not a given curve will progress. However, the Scoliosis Research Society (SRS) has compiled data suggesting the probability (risk) of progression as follows:
Data generated by the SRS, Chicago, Illinois
As shown with this table, the larger the curve is and the younger the child the greater the risk of progression. Scoliosis curves progress most rapidly during the growth spurt, which is usually between 11-13 years in girls and 13-15 years in boys. However these are just rough estimates and the growth spurt can occur earlier or later
The international Society on Scoliosis Orthopedic and Rehabiliation Treatment (SOSORT), a leading scientific medical society on scoliosis, in 2006 composed and published a consensus papers on ?Why do we treat adolescent idiopathic scoliosis? The consensus paper, compiled the following list:
#1 Aesthetic Longevity – Achieving more symmetrical body/torso appearance
#2 Quality of Life – Maintaining normal daily living activities
#3 Back Pain – Minimizing the impact of chronic back pain
#4 Psychological Well -Being -Feeling comfortable in one’s body despite spinal deformity
#5 Progression in Adulthood – Alter the natural course of progression into adulthood
#6 Treatments into Adulthood – Creating treatments for adults that can be performed at home
#7 Breathing Function – Maintaining optimal body oxygenation
#8 Radiographic and Clinical Data – Symmetry of the spine on x-ray
#9 Posture, Balance, and Movement – Symmetry of visual posture and maintaining balance
#10 Cognitive – Preventing mental decline from brain asymmetries
Many conservative treatment systems advertised on the internet may claim to “correct” scoliosis. Be wary of these un-proven claims. To date the only treatment conclusively proven to actually correct a scoliosis is surgery. Significant studies have been done on scoliosis treatment and the medical community has been able to conclude that conservative treatment can prevent a scoliosis from getting worse and that the most effective conservative treatment modality is rigid bracing. Nevertheless, the newer more modern bracing designs such as The LA BraceTM are starting to show some signs of regression of curves, particularly when combined with the Schroth therapy method (see www.schrothmethod.com). As more and more patients receive these treatments, more evidence is tabulated and eventually it will be determined scientifically if these advanced conservative treatment options can claim to “correct” scoliosis.
Bracing systems for scoliosis fall into five categories:
- Milwaukee/Superstructure Braces.
- Symmetrical Rigid Braces with Correction Pads. Boston Brace, Wilmington Brace. Lyon Brace, Sport Brace.
- Night-Time Only Braces Hyper-corrective 2D Braces. Charleston Brace, Providence Brace. Designed for night time only use.
- Cheneau Type Hyper-Corrective 3D Braces – The LA BraceTM, Rigo-System-Cheneau Brace, Scoliologic Cheneau Light Brace
- Soft, Flexible Braces – Spine-Cor.
Of these options, The L.A. BraceTM represents the most technically advanced and most effective design of scoliosis brace. For more information please visit the Brace Information page