Scoliosis

Definition

Scoliosis is a developmental disorder that causes the vertebrae to deform, twist and tilt sideways, resulting in an S or C-shaped spine.

The forms of scoliosis are:

Congenital, which is created in the first weeks of fetal life

Neuromuscular, which is caused by diseases of the nervous or muscular system

Idiopathic, which makes up the largest percentage and is of unknown etiology. This condition is usually symptomless and starts in childhood.

Functional, which is caused by external causes and is fully restored when the cause is eliminated. The most likely causes of functional scoliosis are severe muscle spasm, anisoscelesness, severe discopathy and poor posture.

Diagnosis

The diagnosis of scoliosis is made by taking into account the clinical and radiological examination. The clinical examination uses Adam's test or epicondylar test, which shows if there is a curve in the spine. If the clinical examination is positive then an X-ray examination follows to confirm initially, and then to determine the severity of the scoliosis. Scoliosis is confirmed when the X-ray shows a lateral tilt of the spine with a Cobb angle of more than 10 degrees, with simultaneous rotation of the spine.

Indications of scoliosis in children

The signs of scoliosis are usually noticed in pre-teenage years. Signs that suggest scoliosis in children usually include:

Tilting the head, hip or waist to one side of the body

Appearance of pain in the back or waist

Assymetry of the hips

Assymetry and bend in the shoulders

Kyphosis (hump) of the chest

Deterioration of respiratory function

Treatment of scoliosis

Scoliosis is measured in degrees and to some extent the treatment depends on how many degrees it is. Scoliosis is divided into 3 categories according to its degrees:

Up to 25 degrees

From 25-45 degrees

From 45 degrees and above

Scoliosis up to 25 degrees can only be treated through specific physiotherapy exercises for scoliosis, with the most widespread and documented method being the Schroth method. These specific exercises help to significantly reduce the likelihood of scoliosis worsening and avoid the need for a guardian. These exercises include strengthening the muscles of the trunk and improving the flexibility of the spine. In cases of more than 25 degrees and if the child is still growing, it is recommended that a special guardian be made and used.

However, because the guardian offers a passive correction of scoliosis, and in this case it is necessary to carry out special exercises that will help to limit it. Finally, when the scoliosis exceeds 45 degrees and if conservative treatment with the use of a wax guard combined with specific physiotherapy exercises have not had the desired effect in controlling the scoliosis, surgery is recommended. The usual surgical procedure is spinal fusion.