scoliosi

What is it?

Scoliosis is a deformity of the vertebral column characterized by a lateral deviation (spine curves to one side) often associated with morphological changes of the vertebrae and of the supporting structures of the spine.

It can affect any part of the spine but the most common regions are the chest and the lower back.

How many types of scoliosis exist?

Basically there are three. The idiopathic scoliosis (most common form – 65%) especially in adolescents due to unknown causes. The congenital scoliosis (15%) due to vertebral malformations that usually occur in the maternal uterus between the third and seventh week of gestation. Finally, scoliosis secondary to neuromuscular disorders such as muscular dystrophies, polio, etc. (10% of cases)

What are the causes?

In the majority of cases (idiopathic form) the causes are unknown.

How can scoliosis be diagnosed?

An accurate clinical evaluation is essential to understand if there is a scoliosis or not and differentiate it from the scoliotic attitude (see below). Patients should be evaluated in the upright standing static position and during walk to better understand deformities. If necessary an X-ray of the entire vertebral column in the upright standing position can be performed (postero-anterior and latero-lateral view) to evaluate possible alterations of the physiological curvatures and vertebral deformities.

scoliosis
X-ray of the vertebral column

What is the scoliotic attitude?

This term refers to the lateral deviation of the column without any deformation of the vertebral bodies. It is generally determined by static conditions regarding specific conditions such as leg length discrepancy, hip dislocation, vertebral and/or muscular pain and weakness of the trunk muscles. An accurate clinical evaluation in upright static standing position and lying of the bed is sufficient to make a diagnosis without any need of X-rays.

In this case, treatment consists of identification of the causes and of their
adequate treatment (adding adequate height to compensate leg length discrepancy; reducing hip’s dislocation; anti-inflammatory assumption and/or physical therapy to treat muscle pains etc).

Are clinical and radiographic follow up necessary?

In case of scoliosis follow up is recommended every 6-8 months in case of skeletally immature patients to avoid further deterioration until the end of body’s growth.

For patients who have reached skeletal maturity the risk of deterioration is minimal.

How can scoliosis be treated?

According to the severity and progression of scoliosis, determined by specific radiographic measurements, different treatments can be performed.

In case of mild scoliosis postural management may be sufficient to control deformity.

In case of severe scoliosis postural management associated to custom-made braces are recommended. Corrective surgery is recommended at any age in severe cases of scoliosis associated to lungs and heart function alterations clinically present.

scoliosis
orthopedic braces

Is it possible to perform sports?

Yes. Several studies carried out over the years demonstrate that normal physical activity is recommended (swimming, tennis, basketball, volleyball, dance, etc.).

In case of physical activity at a professional level discussion with the specialist of all the risks associated with this choice is reccomended.

What is the duration of scoliosis?

At the end of body’s growth the scoliosis usually remains stable during the entire lifetime and does not affect the quality of life.