Scoliosis

Aimee Morse

Professor Bradford

BIO 254 H1
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Scoliosis is an abnormal lateral curve of the vertebral column. It is most prevalent in

women and affects over 12 million Americans in varying degrees. Scoliosis can be a serious

condition that if left untreated can result in death due to complications created by the

curvature. Despite its prevalence, most cases of scoliosis are considered mild.

A normal vertebral column is composed of seven cervical vertebrae, twelve thoracic

vertebrae, and five lumbar vertebrae. Every vertebral column has some curvature to it. The

main function of the vertebral column is protection of the spinal column. Other functions

include helping the body stiffen and providing attachment sites for muscles and weight bearing

so that an individual can walk upright.

There are two types of scoliosis: dextroscoliosis and levoscoliosis. Dextroscoliosis occurs

when the vertebral column curves to the right; while levoscoliosis occurs when the vertebral

column curvatures to the left. Scoliosis is further divided by the amount of curvatures

displayed. An individual can either have a “C” shaped curve or an “S” shaped curve, indicating

two curves. The single “C” curve is more prevalent.

Signs of scoliosis include: uneven shoulder blades, one shoulder blade protruding more

than the other, an uneven waistline, and one hip being raised higher than the other. As the

curve progresses the ribs will start to protrude more on one side of the body than the other

side. Around this time the vertebral column will also start to twist and rotate. This is the

body’s attempt to compensate for and correct the curvature. Most individuals do not

experience any pain or even know they have scoliosis until the curvature progresses to the

point where it is externally noticeable.

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Scoliosis does not just affect the vertebral column. In severe cases of scoliosis other

complications can arise. Lung and heart damage, along with chronic back pain, numbness and

muscle weakness are also symptoms of scoliosis. Lung and heart damage occur when the rib

cage starts to press up against these organs. This prevents the lungs cannot fully inflate,

making it harder to breathe; which in turn makes it harder for the heart to pump because it has

less space to fill. Numbness occurs due to the curvature cutting off or pinching the nerves the

vertebral column is created to protect. Muscle weakness happens because the curvature is

putting unnecessary strain on the back muscles. These muscles are working overtime to

prevent the curvature from progressing.

Most cases of scoliosis are idiopathic meaning doctors are unsure what causes the spine

to curve. Before this diagnosis can be given the doctor must determine if the scoliosis is

nonstructural or structural. Nonstructural scoliosis is a temporary and changing curve. It is

caused by another issue within the body such as leg length. A doctor will correct the underlying

issue which also corrects the scoliosis. Structural scoliosis is a fixed long standing curve. These

curvatures are caused by different syndromes or diseases, such as by neuromuscular

conditions, birth defects that affect the development of spinal bones, injuries or infections to

the spine. These issues are less common, but can play a part in scoliosis. Hereditary factors are

also believed to be involved because scoliosis has a tendency to run in families. It is also

believed scoliosis can be caused by large growth spurts that the body is unable to compensate

for. Due to the rapid increase in change the spine is unable to keep up and maintain its proper

shape.
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Treatments of scoliosis can range from observation to surgery. When an individual is

first diagnosed with scoliosis the doctors make a decision based on the severity of the

curvature, the age of the individual, and the potential progression of the curve. The severity of

the curvature is important because that will determine how aggressive the treatment will be.

Since most cases are mild observation is the only necessary means for treatment. Routine x-

rays provide the doctor with the necessary information on how to best treat the individual. The

next factor is age. The younger the individual is the less likely the doctors are to suggest

anything other than observation, unless the curve is severe. If the individual is fully grown

there is a greater chance surgery will be recommended.

Another practical option is bracing. As a curve progresses observation is not enough. At

this point a patient will be fitted for a brace to prevent the curve from progressing more. This

will not cure the scoliosis, but is a preventative measure. Most are made from plastic and fit

similarly to a corset. They are most effective when they are worn at all times. In some cases

this is enough to let the individual live a normal life. Once an individual has stopped growing a

brace is no longer necessary. At this point the bones have stabilized and chances of progression

are slim.

In severe cases surgery is the only option for an individual. A spinal fusion is performed

to prevent the spine from continuing to progress and reduce the severity of the spine. In these

cases the curvature has progressed far enough that it is cutting off lung capacity and interfering

with other organ’s normal function. In a spinal fusion the spinous processes of the vertebrae

are removed and wedged between the vertebrae to form a single bone. Other options include
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an autograft from the hip body or bone from a bone bank. Once the bones are set, Harrington

rods, screws, and hooks are attached in various places to secure the bones.

Alternative options for treatment include: traction therapy, exercise, and chiropractic

manipulation. Traction therapy also called halo-gravity traction is the practice of lifting the

head and gently pulling it to decompress the vertebral column. The individual is strapped into

the machine that holds their head up and straps their body to a chair, letting another individual

manipulate the other’s body. This practice has been successful in patients, but is known to

cause a lot of pain to the individual. The problem with this practice is it allows the vertebral

column to be stretched, but does nothing to prepare the muscles for maintaining the

straightened spine. Exercise has been known to help because it helps strengthen the back

muscles so they can maintain and stabilize the vertebral column. The stronger the muscles the

harder it will be for the bones to push against and curve. Chiropractic manipulation can help

because proper alignment alleviates strain on the muscles and keeps the vertebral column

curvature from progressing. Exercise and chiropractic manipulation have been found to be

successful for individuals with mild scoliosis and do help alleviate pain in moderate to severe

cases.

Most people with scoliosis can live a normal lifestyle no matter what method of

treatment is given. Since majority of the cases are mild there are no real consequences or

problems faced by these individuals. In the moderate cases, bracing is an effective way of

preventing progression. In severe cases surgery is the only option. In most cases it is the most

effective treatment because it stops the curvature from progressing. There are some rare cases

where the spine will continue to curve even after surgery. In other rare cases the Harrington
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rods are removed from the body due to complications. Because there is a greater likelihood

the curvature will start to progress again, an individual is routinely monitored to prevent this

from happening. If an individual does not seek treatment the curve will continue to progress.

Since most cases are mild this is not an issue. But for those with moderate to severe cases lack

of treatment could result in extensive damage to vital organs, excruciating pain, and in some

cases death.

Scoliosis is affecting 12 million Americans. Most cases are mild and are easily treated.

Since scoliosis can progress quickly early detection is one of the best methods for prevention.

The best ways to prevent scoliosis are exercise to build strong muscles to support the vertebral

column, regular chiropractic visits to maintain proper alignment, and regular physicals with a

doctor to monitor any changes. Though scoliosis can be debilitating, most individuals continue

to lead a normal lifestyle.

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References

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<http://www.niams.nih.gov/Health_Info/Scoliosis/default.asp>.

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