Scoliosis

Scoliosis cap be classified according to the age of onset:

• Congenital scoliosis develops soon after birth due to abnormal formation of the spine.
• Juvenile scoliosis is usually detected between 4 and 10 years of age.
• Adolescent idiopathic scoliosis (AIS) occurs after 10 years of age and is the most common type. 

Scoliosis often does not cause pain, especially in children:

• It usually does not lead to neurological symptoms.
• Early-onset scoliosis can affect lungs and heart development due to the chest being compressed.
• Adolescent with scoliosis are often more concerned about body appearance, such as uneven shoulders, hips, or a visible curve in the back.

The cause depends on the type of scoliosis:

• Congenital scoliosis results from abnormal spinal development before birth.
• Juvenile and adolescent scoliosis may develop without a clear cause (idiopathic).
• Other possible factors include neuromuscular conditions, connective tissue disorders, or a family history of scoliosis.
   

Doctors use physical examination and imaging tests to confirm scoliosis:

• A thorough clinical examination is done to measure the degree of spinal curvature, identify the cause, and check for signs of nerve involvement.
• Spine X-ray shows the location and severity of the curvature and identifies any bony abnormality.
• Spinal MRI to determine the status of the neural tissue. Additional investigations may be required depending on the patient.

Treatment depends on the severity of scoliosis and the age of the patient.:  

• Non-surgical treatment includes bracing, which is recommended for children with mild deformity to prevent worsening as they grow.
• Surgical treatment involves correcting the deformity using screws and rods. This is also done as a palliative procedure to decrease the compression on important structures like the lungs.
  • This complex procedure requires a specialised team, including a spine surgeon, anaesthetist, physician, and physiotherapist.
  • Highly skilled surgeons with extensive experience are needed to achieve favourable outcomes.
  • Rehabilitation post-surgery is crucial to provide excellent results. 

Medical advice should be sought if:

• There are visible signs of uneven shoulders, hips, or ribs.
• The child complains of breathing difficulties or reduced stamina.
• There is rapid worsening of the curve.
• Back pain or neurological symptoms (numbness, weakness) are present.

There are no guaranteed ways to prevent scoliosis. However:

• Early detection through regular check-ups during school-age years is important.
• Specific steps may be taken to preserve spine health: Good posture and regular physical activity.

• A paediatrician for initial assessment in children.
• An orthopaedic doctor or spine surgeon for diagnosis and treatment planning.
• A physiotherapist for posture correction and rehabilitation.