Scoliosis: Lateral Curvature of the Spine

Scoliosis: is a sideways curvature of the spine. It can affect any part of the spine but is most common in the thoracic (chest) and lower lumbar regions. It usually appears in children. In most cases, treatment is not required because the curve often improves naturally as the child grows. However, depending on the degree of curvature and the child’s age, a combination of bracing and physiotherapy is usually recommended. Only a small number of patients require surgery. Complications include chronic pain, breathing difficulties, and reduced athletic ability. The spine may curve into a C or S shape. Scoliosis may appear at any age but is most common between ages 10–12 or during adolescence. Infants can also show symptoms. The cause is often unknown, but some cases are associated with cerebral palsy, muscular dystrophy, spina bifida, or congenital abnormalities. Most children have mild curvature that does not require treatment. It is recommended to monitor the child every 4–6 months with an X-ray. Factors doctors consider when choosing treatment: • Sex: Girls are more likely to develop worsening scoliosis. • Severity: Larger curves worsen more quickly. • Curve type: S-shaped curves worsen more often than C-shaped curves. • Curve location: Curves in the middle of the spine tend to progress more. • Bone maturity: Braces are more effective while bones are still growing. For infants, casting may be used to help guide the spine back to normal as they grow. In moderate scoliosis with ongoing bone growth, a brace is recommended. It prevents the curve from worsening but does not cure or reverse it. Braces are worn most of the day and can be removed for physical activities. Types of braces: • TLSO: Plastic, custom-fitted, and usually invisible under clothing. • Milwaukee brace: Used only when TLSO is not effective or suitable. Symptoms in children and adults: • Off-center head position • Asymmetric rib cage • One hip more prominent • Clothes hanging unevenly • One shoulder higher • Body leaning to one side • Unequal leg length Symptoms in infants: • Chest bulge on one side • Preference to lie on one side • In severe cases: heart and lung issues, shortness of breath, chest pain Exercise programs help improve posture but research is still ongoing to determine the most effective ones. Surgery: In severe cases, scoliosis may progress, and spinal fusion surgery may be recommended. Metal rods help keep the spine straight during healing. The surgery lasts 4–8 hours. Afterward, the child spends 24 hours in the ICU and stays in the hospital for 7–10 days. Most return to school after 4–6 weeks and can resume sports after about 1 year. Some may need a back brace for 6 months after surgery.