Scoliosis is defined as a sideways curve of the spine to the right and /or left sides. Scoliosis could develop in any of the three regions of the spine: lumbar, thoracic, or cervical).
The shape of the scoliosis curve could be C-shaped or S-shaped.
A person’s scoliosis is named by the region of the spine involved, and the side that the curve goes to. For example: a right thoracic scoliosis means thoracic spine curves to the right side.
Types of Scoliosis
There are two types of scoliosis: functional (or postural) and structural.
In a functional or postural scoliosis, the spine is curved to the right or left side with no rotation of the vertebral bones. This type of scoliosis could be due to a difference in the length of the person’s legs, or due to poor posture. A functional scoliosis can usually be corrected through physical therapy.
With a structural scoliosis the vertebral bones are rotated, (in addition to the sideways spinal curve that is characteristic of a functional scoliosis). About 80% of structural scoliosis have no known cause. It typically appears first in adolescence, occurring in girls 5 times as much as in boys.
A structural scoliosis is more serious when it involves the thoracic spine (mid back), because the shift of the rib cage can interfere with lung and heart function. The curves of structural scoliosis can rapidly increase during adolescence as much as 10 degrees a year. Early detection and proper treatment are critical to prevent possible severe consequences from getting progressively worse.
Treatments for Scoliosis
Scoliosis curvatures are classified as minor, mild or severe. Curves are best measured with X-ray, and labeled by the number of degrees of deviation of the curve from what would otherwise be a straight vertical spine. Mild to minor curves have 15 to 20 degrees of deviation. Adolescents whose curves fall within this range should have a thorough evaluation, learn postural exercises from a physical therapist, and follow up closely by a spine specialist to monitor the possible progression of the curve.
If a steady worsening of the curve is seen, a brace is usually recommended. The research shows that for progressive scoliosis, the best results are achieved using both proper exercise and bracing.
The intent of an exercise program is to improve range of motion of the spinal joints, as well as to improve the strength and flexibility of the muscles along the spine. The exercises should be continued until the periodic x-rays indicate that maximal spinal correction and stability is achieved.
Experts uniformly agree that severe curvatures, those greater than 40 to 50 degrees of deviation should be surgically fused.