Understanding Scoliosis

Scoliosis, a complex spinal curvature condition, affects a significant portion

of the US population, primarily developing during adolescent growth
spurts. Early detection and intervention are crucial for managing its
progression and improving long-term outcomes. This presentation aims to
provide comprehensive information, empower individuals with knowledge,
and foster a deeper understanding of scoliosis.

SN by Simran Nirman
What is Scoliosis?
Lateral Spinal Curvature Measuring the Cobb Angle

Scoliosis is defined by a lateral curvature of the spine The severity of the curve is precisely measured using the Cobb
measuring more than 10 degrees. This curvature can occur in angle, a standard metric obtained from X-ray imaging. Visually,
various sections of the spine, including the thoracic (mid- scoliosis may manifest as uneven shoulders, hips, or an
back), lumbar (lower back), or thoracolumbar (junction of mid asymmetry in the waist, often becoming more noticeable
and lower back) regions. during growth spurts.
Types of Scoliosis
Idiopathic Scoliosis
This is the most prevalent form, accounting for about 80% of all
cases, with its exact cause remaining unknown. It typically develops
during adolescence.

Congenital Scoliosis
Present at birth, this type results from malformations in the
vertebrae during fetal development.

Neuromuscular Scoliosis
Linked to underlying conditions like muscular dystrophy or cerebral
palsy, where muscle weakness or imbalance affects spinal support.

Degenerative Scoliosis
This form develops in adulthood due to age-related wear and tear,
such as arthritis or disc degeneration.
Prevalence and Risk Factors

2-3% 10-15 2x
Population Affected Typical Onset Age Female Predominance
Scoliosis affects approximately 2-3% of The condition commonly manifests Scoliosis is observed to be more
the global population, translating to between the ages of 10 and 15 years, common in females than in males, and
around 6-9 million individuals in the coinciding with rapid growth spurts. curves in females are more likely to
United States. progress and require treatment.

Family history also plays a significant role, as having a close relative with scoliosis can increase an individual's risk of developing
the condition. Awareness of these factors can aid in early identification.
Symptoms of Scoliosis
Visible Spinal Curvature
The most apparent symptom is a noticeable curve in the spine.

Uneven Shoulders or Hips

One shoulder blade may appear more prominent or one hip higher
than the other, leading to clothes hanging unevenly.

Rib Hump and Pain

When bending forward, a noticeable rib hump may appear on one side
of the back. Back pain or stiffness can also be present.

Severe Complications
In very severe cases, the spinal curvature can impact lung capacity
and put strain on the cardiovascular system.
Diagnosis and Evaluation
Physical Examination
A thorough physical exam assesses overall spinal alignment and
posture.

Adam's Forward Bend Test

This classic screening test involves bending forward at the waist
to check for any asymmetry in the back, such as a rib hump.

X-ray Imaging
Full-length X-rays of the spine are crucial for measuring the
Cobb angle, which quantifies the degree of curvature, and
assessing vertebral rotation.

MRI Scan
An MRI may be ordered to rule out any underlying
neurological or spinal cord abnormalities contributing to
the scoliosis.
Treatment Options:
Observation
1 Mild Curves
For Cobb angles less than 25 degrees, especially in growing
individuals, observation is the primary approach.

2 Regular Monitoring
Patients undergo regular check-ups every 4-6 months to
track the progression of the curve.

3 Physical Therapy
Physical therapy focuses on strengthening core muscles,
improving posture, and maintaining spinal flexibility to
support overall spinal health.

Observation is a careful, wait-and-see strategy to ensure the curve does not

worsen significantly during a child's growth.
Treatment Options: Bracing
Ideal Candidates
Bracing is typically recommended for growing children and
adolescents with Cobb angles between 25 and 45 degrees.

Primary Goal
The main objective of bracing is to prevent the curve from
progressing until skeletal maturity is reached.

Wearing Schedule
Braces are generally worn for 16-23 hours per day to be
most effective in managing curve progression.

Common Types
Popular brace types include the Thoraco-Lumbo-Sacral
Orthosis (TLSO), also known as the Boston brace, and the
Milwaukee brace.
Treatment Options: Surgery
Indications for Surgery Spinal Fusion

Surgical intervention is typically considered for severe curves, The most common surgical procedure is spinal fusion, where
usually those with a Cobb angle greater than 45-50 degrees, the curved vertebrae are fused together using bone grafts,
especially when bracing has failed to halt progression. The rods, and screws. This stabilizes the spine and corrects the
decision is made after careful consideration of the patient's curvature. A newer, less invasive option, Vertebral Body
age, skeletal maturity, and curve characteristics. Tethering (VBT), is available for select patients, offering
flexibility preservation.
Living with Scoliosis
Community Support
Connecting with support groups and patient communities offers
emotional support and shared experiences, fostering a sense of
belonging and understanding.

Active Lifestyle
Engaging in regular exercise and maintaining a healthy lifestyle
are vital for managing symptoms, strengthening muscles, and
promoting overall well-being.

Ongoing Care
Consistent follow-up appointments with healthcare providers are
essential to monitor the spine's condition and adjust treatment
plans as needed.

Advances in scoliosis treatment, including innovative surgical techniques

and non-surgical management, continue to offer improved outcomes and
enhanced quality of life for individuals living with the condition.