By Don O Stovall, Jr., MD
Abnormal Curvature of the Spine
NORMAL SPINE CURVATURE
In the normal spine, the neck has a forward curve, called lordosis. The thoracic or dorsal spine develops a normal posterior curve called kyphosis. The lumbar or lower portion of the spine develops a normal lordosis.
ABNORMAL SPINE CURVATURE
A lateral curve in the spine is called scoliosis. This can develop in a child or in an adult due to a variety of causes. In children, scoliosis can be caused by congenital malformations, neuromuscular diseases like cerebral palsy and muscular dystrophy, or tumors. In adults, scoliosis can be caused by trauma, arthritis, or degenerative disc disease. Most often, however, the cause of scoliosis is unknown and is therefore called idiopathic scoliosis.
Idiopathic Scoliosis - occurs during three separate time periods:
- Infantile idiopathic scoliosis: Between birth and three years of age
- Juvenile idiopathic scoliosis: Between the ages of three and ten years
- Adolescent idiopathic scoliosis: Between ten years and skeletal maturity
Adolescent idiopathic scoliosis is by far the most common type. It is genetic in nature and tends to occur in families. Although the incidence is equal in boys and girls, girls tend to have larger curves that require treatment more often. Curves tend to progress most rapidly during the adolescent growth spurt. This is the most critical time period in which early diagnosis and treatment can be effective in preventing the long-term consequences of untreated scoliosis. Gone untreated, progressive scoliosis can cause unsightly deformities, painful degenerative back problems, and heart and lung complications.
Because idiopathic scoliosis is not usually painful, careful screening is important for all adolescents to discover which patients may have scoliosis and which may require treatment. Although most causes of scoliosis are unknown, some causes in adolescents such as leg length inequality, benign bone tumors, or psychological factors, can be easily and effectively treated In most cases of idiopathic scoliosis, simple observation and periodic examinations and x-rays are all that is needed. Other patients may need brace treatment or even surgery to prevent the curve from getting worse.