Scoliosis
What is scoliosis?
Scoliosis means that your spine, or "backbone," is curved.
What causes scoliosis?
There are different types of scoliosis and different reasons that might cause your spine to curve.
- The most common type of scoliosis is called idiopathic scoliosis, which means the cause is unknown. It occurs more in girls and in families. The back just doesn't grow as straight as it should, and no one knows why.
- Sometimes, the spine appears to be curved because of a difference in leg length. This is less common.
- Some babies are born with spinal defects that cause the spine to grow unevenly. This last type of scoliosis is rare and is called congenital scoliosis.
Who gets scoliosis?
Anyone can get scoliosis. The most common type of scoliosis, idiopathic scoliosis, usually occurs after age 10. Boys are less likely to develop idiopathic scoliosis then girls are.
Check out this list of some famous people with scoliosis:
- James Blake – Professional Tennis Player
- Kurt Cobain - Famous Rock Singer
- Janet Evans - Olympic Swimmer
- Sarah Michelle Gellar - Actress/Model
- Daryl Hannah - Actress
- Dudley Hart – Golf Player
- John Lydon (Johnny Rotten) - Lead Singer of the Sex Pistols
- Jon Olson – Olympic Swimmer
- Alexandra Marinescu - Olympic Gymnast
- Isabella Rossellini - Actress/Model
- Renee Russo - Actress/Model
- Chloe Sevigny - Actress
Everyone between fifth and ninth grade should be checked for scoliosis by their health care provider. It is especially important to be checked regularly if you have a parent, brother, or sister with scoliosis, since scoliosis can run in families.
How is scoliosis diagnosed?
Scoliosis is diagnosed by physical examination, which sometimes may include an X-ray evaluation and curve measurement.
- Physical Examination
Your health care provider will look at your back, chest, hips, legs, feet, and skin. He or she will check to see if your shoulders are even, whether your head is centered over your shoulders, and whether opposite sides of your body look even. He or she will also examine your back muscles, while you are bending forward, to see if one side of your rib cage is higher than the other. If there is a significant asymmetry (a big difference between opposite sides of your body), your health care provider may suggest an x-ray or a referral to an orthopedic spine specialist (a doctor who has experience treating people with scoliosis).
- X-ray evaluation
If you have a medium or large spinal curve, unusual back pain, or you still have a lot of growing to do, your health care provider will arrange for you to have an X-ray. You will be asked to stand facing the X-ray machine. An X-ray is a detailed picture of your spine. Your health care provider will be able to see any curves in your spine and can figure out if they need to be watched or treated.
- Curve measurement
Your health care provider will measure the curve on the X-ray image. He or she finds your vertebrae at the beginning and end of the curve and measures the angle of the curve. Curves that are greater than 20 degrees may need treatment.
What kinds of treatment are available?
Depending on the location, degree (severity) of the curves, and growth remaining, your health care provider will recommend observation, bracing, or surgery.
- Observation
Some curves get worse with growth. Others don't change and some may even get better. Some curves require no treatment. However, your health care provider will want to watch your curve carefully to make sure that it does not get worse as you grow.
- Bracing
If your curve is large enough and you are still growing, your doctor may recommend a brace. The scoliosis brace is designed for you and your particular curve. It holds your spine in a straighter position, and it helps prevent your curve from getting worse while you are growing. A brace will not make your spine straight, but it can help improve the curve or prevent it from getting worse.
Your doctor will give you specific directions about how to put on your brace, when to wear it, and how long to wear it. The brace needs to be worn for the full number of hours prescribed by your doctor until you finish growing.
The braces are made of firm plastic and fit closely over the hips. Almost all braces can be hidden beneath clothing, and you can continue to do all athletic activities. Generally, braces can be removed for activities such as showering, swimming, and sports.
- Surgery
Bracing does not work for everyone and every curve. If you have a very large curve or one that does not stop getting worse with a brace, your doctor will probably recommend surgery.
There are different types of surgery. Some may be better for your specific curve than other types. The main purpose of scoliosis surgery is to fuse (join together) the bones of your curve. The fusion keeps your spine straight.
Your surgeon will talk to you about your options, the different types of surgery, and the different types of implants available. Implants are devices that are inserted during surgery. They remain in your back after surgery and help keep your spine straight.
If you are considering surgery you should be sure to ask your surgeon the following questions:
- What will happen if I don't have surgery?
- What type of surgery will work best for me?
- What implants will be used?
- How straight will my spine be after surgery?
- How long will the operation take?
- What are the risks of this surgery?
- What are the benefits to getting this type of surgery?
- What is the scar like?
- How long will I have to remain in the hospital after the surgery?
- How long will it take to recover?
- When can I start being as active as I was before surgery?
- What permanent restrictions are there on activity?
- Can I talk to another patient/family who had the surgery?
What will happen if I ignore my scoliosis?
It is very important to treat scoliosis since spinal curves can become worse and cause physical changes to your spine. It is also important to treat curves since treatment is much more successful before curves become severe. In the worst cases, scoliosis can cause changes in your chest and lungs and difficulty breathing.
How do I cope with scoliosis?
If you are diagnosed with scoliosis, you can still live a healthy and active life. Most teens with scoliosis are able to exercise, take part in sports and athletics, drive, and be involved in friendships and relationships. Teens with scoliosis can do pretty much everything that teens without scoliosis can do.
Remember that if you are diagnosed with scoliosis, it is not your fault. Nothing you did caused the scoliosis, and there is nothing you could have done to prevent it. If you have scoliosis, the important thing is for you and your health care provider to choose and follow the best treatment plan for you.
Written by the CYWH and YMH Staff at Children's Hospital Boston
Updated: 11/23/2009
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