What is Scoliosis?

Scoliosis

The healthy human spine is relatively straight when viewed from behind and has a natural S-curve when viewed from the side. A spine with scoliosis substantially bends, rotates, and/or twists from that shape, and in more severe cases causes difficulty standing, walking, and breathing. It affects 2-3% of the world’s population, or 6-9 million people in the United States alone. Adolescent onset scoliosis is most common, and there is no known prevention. Some level of degenerative scoliosis is present in about two-thirds of all people aged 60 and older. Early diagnosis and treatment are important to mitigating adverse effects.

Symptoms

The most common indication of scoliosis is a spine that bends to the left or right when viewed from behind. This causes the patient to have uneven shoulders, a head that’s not centered above the pelvis, and a visible difference in hip height. These indications can be seen quite clearly in a standard torso X-ray. However, a spine with scoliosis also often twists and rotates in other dimensions, causing one side of the rib cage to protrude, sciatica, and difficulty walking. These distortions are harder to see in typical X-rays, and therefore may not be properly treated.

Scoliosis Types

Idiopathic

This is the most common form of scoliosis. “Idiopathic” means that the disease has no identified cause, and these account for about 80% of all pediatric scoliosis cases. Family history and genetics may be risk factors.

Degenerative Scoliosis

Asymmetrical degeneration of the spinal discs can cause the spine to increasingly bend and distort with age.

Neuromuscular Scoliosis

This form of the disease is caused by nerve and muscular conditions including cerebral palsy, muscular dystrophy, and Angelman syndrome.

Screening and Monitoring

Prior to NSite, here are the most common methods used for diagnosing and monitoring scoliosis:

Manual

The most common adolescent screening method has been to manually assess the curvature of the spine while the patient bends over to touch toes. This method can miss up to 30% of cases.

MRI

Similar to X-rays but without the radiation, MRIs provide detailed images but require even more expensive equipment.

X-rays

This method provides a very clear view of the spine and provides the physician detailed information to both identify and monitor the disease. There are numerous downsides to this method, however: 1) It only provides information in two dimensions and can miss spinal twists and rotations; 2) Repeated radiation is a substantial risk factor for other diseases, including cancer; and 3) High price.

Screening and Monitoring

Treatment & Therapy

Bracing has historically been the most common option, and is still frequently used in pediatric scoliosis cases where the spinal curve is 20 to 40 degrees. However, in order for bracing to be effective, scoliosis curves must be detected early. Exercise, physical therapy, and a treatment regimen known as the Schroth method can also help. For more extreme cases, surgery may be indicated. In almost all treatment regimens, frequent monitoring of the spine is important to assess treatment impact.