The Spine and Scoliosis

The Spine and Scoliosis
The spine has an important role. The spine supports our erect posture, stabilizes our limbs relative to our trunks, supports our abdominal and thoracic regions, and protects our neural elements. The spine is in balance when the head is aligned with the pelvis. Scoliosis is a condition in which the spine is curved in the coronal or frontal plane. The coronal plane is the view from the crown (corona) of the head down. The frontal plane is the view of the body from the front. Scoliosis encompasses curves of 10 degrees and greater.

Scoliosis may be caused by:

• abnormalities in the vertebra at birth.
• neuromuscular disorders, such as cerebral palsy, myelomeningocele, or paraplegia.
• connective tissue abnormalities, such as osteogenesis imperfecta, Marfan's syndrome, or Ehlers - Danlos syndrome.
• other injuries to the developing spine.

In the adolescent, the most common cause of spinal deformity is idiopathic which means unknown. While the cause of adolescent idiopathic scoliosis remains unknown, we are currently researching possible causes that may include genetic predisposition, vestibulobasilar or central nervous system causes, or growth pattern asymmetries. It appears most likely that adolescent idiopathic scoliosis is the result of multiple factors including genetic and environmental influences.

By age 16, the prevalence of Adolescent Idiopathic Scoliosis in:

• curves >10° affects 2-3%
• curves >20° affects 0.3-0.5%
  

That means, approximately 3 to 5 people in every large high school are affected. Screening for scoliosis is an attempt to identify the disorder at an early stage, but screening varies across communities. Often, family or friends first detect scoliosis in an adolescent by noticing an asymmetry in the shoulders, rib cage, waist, or pelvis. Screening is useful if early identification permits treatment that may halt the progression of the deformity. While scoliosis screening programs remain an entrenched policy in many school systems, there is little evidence that screening contributes to improving management or reducing surgical rates for scoliosis. Though, a physician should routinely screen siblings of a patient with scoliosis.