Scoliosis is a disorder that causes an abnormal curve of the spine, or backbone. The curve can bend to the left or to the right and can be in the lower part of the spine (a lumbar curve), in the upper part of the spine (a thoracic curve) or go from the upper to lower part of the spine (a thoraco-lumbar curve). In some cases there is a double curve – like an S shape.
To be defined as having a scoliosis one must have a side to side curvature of greater than ten degrees as measured by the Cobb angle. The Cobb Angle is measured by identifying the most tilted vertebra at the top of the curve and the most tilted vertebra at the bottom of the curve. A line is drawn from the upper edge of the vertebra at the top and the second line from the lower edge of the vertebra at the bottom of the curve. Where the lines cross is the Cobb angle. There is a standard error of 5 degrees; therefore changes below 5 degrees are not significant. The Cobb angle is the universal standard to diagnose scoliosis and to assess whether a curvature has stabilized or is getting worse.
An estimated 65% of scoliosis cases are idiopathic, about 15% are congenital and about 10% are secondary to a neuromuscular disease
The most common type of scoliosis is Idiopathic, meaning it has no known cause. Idiopathic scoliosis can be broken down into age groups, based upon onset of curvature.
- Infantile: Age 0-4
- Juvenile: Age 4-10
- Adolescent: Age 10-18
- Adults: over age 18
Congenital scoliosis is where there are vertebral anomalies present from birth.
Scoliosis formed as a secondary symptom to a neuromuscular disease can be seen with conditions such as spina-bifida, cerebral palsy, spinal muscular atrophy, or physical trauma.
Scoliosis is generally classified as Mild, Moderate or Severe. Scoliosis is measured in degrees by a measurement known as a Cobb angle.
- Mild scoliosis – if the Cobb angle is 10 degree to 24 degree
- Moderate scoliosis – 25 – 50 degree
- Severe scoliosis – over 50 degree
Any measurement under 10 degree is not considered to be scoliosis.
Signs and Symptoms of Scoliosis include:
- One shoulder is higher than the other
- One hip is higher than the other
- One shoulder blade protrudes from the back
- The waist line is flat on one side and not flat on the other
- Asymmetric size or location of breast in females
- Head is not centred directly above the pelvis
- Leaning of entire body to one side
- Unequal distance between arms and body
- Rib cages that are at different heights
- Visible difference in look or texture of skin overlying the sides of the spine
- Ribs are more prominent