What
Is It?
Scoliosis is a medical term taken from a Greek word
meaning curvature. This disease is known to develop in adults over the age
of 18 causing the spine curve laterally (to the side) to the left or
right. Adult scoliosis is caused by:
1. Progression
of the disease from childhood. This usually occurs when scoliosis is not
treated early or went unnoticed during childhood. The scoliotic curves may
be thoracic, lumbar, or both.
2. The
asymmetric degeneration of spinal elements. This may be caused by
osteoporosis (porous bone), disc degeneration, compression fracture, or a
combination. These conditions usually affect the lumbar spine and can
affect vertebral height, shape, or basic structural integrity.
3. Combination
of numbers 1 and 2.
The spine's
normal curves occur at the cervical, thoracic, and lumbar regions. These
natural curves position the head over the pelvis and work as shock
absorbers to distribute mechanical stress during movement.
The normal
spine viewed posteriorly (from behind) appears straight from neck to
buttocks. However, a scoliotic spine bends to the left or right resembling
the letter S or C.
Scoliosis is
a complex three-dimensional disease. To understand this concept consider
that in some cases, as the spine curves abnormally, the involved vertebrae
are forced to rotate. If rotation occurs at the thoracic level of the
spine, vertebral turning impacts the rib cage and may result in rib
prominence on the opposite side of the curve.
In severe
cases, lung and heart function can be compromised. Back pain is the
primary complaint. Pain is more common and severe in the lumbar spine.
When the pain is thoracic, rest often alleviates it. This may be confused
with arthritis pain.
Although
scoliosis is known to cause deformity (e.g. humpback), seldom is this the
catalyst that brings the patient to a physician. Scoliosis may cause the
patient's ears, shoulders, rib cage, and pelvis to lack symmetry. An
asymmetric pelvis can lead to trunk imbalance and may make the patient
appear as though listing to one side.
Scoliosis can
cause rib prominence on one side and leg length discrepancy, which often
results in gait dysfunction. Pain, difficulty sitting or standing,
stiffness, and spinal rigidity are often associated with scoliosis. Rarely
does adult scoliosis adversely affect cardiopulmonary (heart and lung)
function or cause neurologic complaints. However, a complete medical and
orthopaedic evaluation by a physician with experienced in adult scoliosis
is essential.
