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Johns Hopkins Symptoms and Remedies

Johns Hopkins Medicine

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Scoliosis

Scoliosis compresses the rib cage on one side and expands it on the other. This may diminish lung capacity on the compressed side.

What is it?

Scoliosis is a sideways, rotational curvature of the spine. A curve to one side, most often in the thoracic (chest) portion of the spine, leads to compensatory bends in the lumbar (lower back) and cervical (neck) portions of the backbone. The resulting S-shape of the spine causes the chest cavity to be enlarged on the wide part of the curve and compressed on the narrow side. In severe cases with large curves, lung capacity can be seriously reduced resulting in heart and respiratory problems. The disorder is often accompanied by a forward or backward curvature, known respectively as kyphosis (humplike) and lordosis (swaylike). Scoliosis usually begins in the years of rapid skeletal growth, between the ages of four and nine, or in the early teens. Adolescent girls are four times more likely to be affected than their male counterparts. Progression usually slows by early adulthood.When detected early, minor deformities may be halted by spine-strengthening exercises and by wearing a brace. More severe cases may require surgery. Scoliosis may worsen with age as a result of degenerative changes, osteoporosis, or loss of muscle strength.

What Causes It?

  • In 80 percent of cases, the cause is unknown, but is probably genetic.
  • In the remaining 20 percent of cases, scoliosis can be attributed to abnormalities such as weakness of the spinal muscles from neuromuscular disease, as in poliomyelitis and Parkinson's disease; spinal injury, such as a fracture; or acquired or inherited defects in the vertebrae.
  • Scoliosis can first appear in older people (55 to 75) without any previous curvature. In these people, the cause is due to the asymmetric wearing out of the spinal column. Such curves usually appear in the lower back.

Prevention

  • There is no known way to prevent scoliosis, but its progression may be arrested after it is diagnosed.

Diagnosis

  • Patient history and physical examination.
  • Spinal x-rays.

How to Treat It

  • When the deformity is slight or associated with muscular weakness, exercises may be recommended. Bracing can be effective in children or adolescents.
  • Frequent physician monitoring is necessary during the rapid growth years to detect significant changes in the curve.
  • Progressing curvatures and curvatures greater than 45 degrees usually require surgery (bone grafting with metal rods) to straighten the spine.

When to Call a Doctor

  • Call a doctor if you suspect scoliosis in yourself or your child. Early treatment can halt its progression.