Spinal curvature
Key points
- Scoliosis is a lateral (away from the middle) or sideways curvature of the spine.
- The idiopathic form in adolescents is the most common and may have a genetic predisposition.
- Note: Kyphoscoliosis also involves abnormal front-to-back curvature, with a "rounded back" appearance.
- The physical examination will include a forward bending test that will help the practitioner define the curve.
Alternative names
Scoliosis; Kyphoscoliosis
Definition
Scoliosis is a lateral (away from the middle) or sideways curvature of the spine.
Causes, incidence, and risk factors
There are three general causes of scoliosis: congenital, usually related to a problem with the formation of vertebrae or fused ribs during prenatal development; neuromuscular (poor muscle control or muscular weakness or paralysis due to diseases like cerebral palsy, muscular dystrophy, spina bifida and polio); and idiopathic (of unknown cause), which appears in a previously straight spine.
The idiopathic form in adolescents is the most common and may have a genetic predisposition. Most cases occur in girls and curves generally worsen during growth spurts. There are also infantile and juvenile forms that are less common and affect a similar number of boys and girls.
Scoliosis may be suspected when one shoulder appears to be higher than the other, or the pelvis appears to be tilted. It is often unnoticeable to an untrained observer, however.
Routine scoliosis screening is now done in junior high school/middle school and many early cases are detected that previously would have gone undetected until they were more advanced.
There may be fatigue in the spine after prolonged sitting or standing. Pain will become persistent if irritation of ligaments results. The greater the initial curve of the spine, the greater the chance for progression of the condition after growth is complete. Severe scoliosis (curves in the spine greater than 100 degrees) may cause breathing (respiratory) problems.
Symptoms
- the spine curving abnormally to the side (laterally)
- shoulders and/or hips appearing uneven
- backache or low-back pain
- fatigue
Note: Kyphoscoliosis also involves abnormal front-to-back curvature, with a "rounded back" appearance. See kyphosis.
Signs and tests
The physical examination will include a forward bending test that will help the practitioner define the curve. There will also be a thorough neurologic exam to look for any changes in strength, sensation, or reflexes.
Tests may include:
- spine X-rays (taken from the front and the side)
- scoliometer measurements (a device for measuring the curvature of the spine)
- MRI (if there are any neurologic changes noted on the exam or if there is something unusual in the X-ray )
Written and revised by
David Cohen, M.D.
Our doctors write and review articles for accuracy and keep them up to date.
health.am provides general information, not medical advice. Always consult a qualified health professional about your own health.