Scoliosis is the three dimensional spine deformity, namely the lateral curvature and rotation of vertebrae.
In other words, we label every curvature of the spine towards one side as scoliosis. The term comes from greek word “scolios”, meaning tortuous. There is no normal lateral curvature of the spine.
It most commonly manifests in adolescence (80% of all cases are adolescents, 1.5%-4.5% of the school population), but it can also manifest earlier, even in infancy. In adult life, a serious degeneration of the spine can result in adult scoliosis.
Its causes vary (genetic, developmental, etc.), but in most cases the causes are unknown. Depending on the cause, there is congenital scoliosis, paralytic-neuromuscular scoliosis, degenerative scoliosis, scoliosis as a concomitant disease of certain syndromes, even post-traumatic scoliosis after a spinal injury. There is also functional or antalgic scoliosis (when someone is in pain, they tilt towards one side to relieve said pain), hysterical scoliosis, etc. However, all these forms which have known causes comprise only 10%-15% of all scoliosis disorders.
In 85%-90% of all cases, it is the so called scoliosis of “unknown origin” or “adolescent” or “idiopathic” scoliosis. This is the most common and most dangerous form, as we DO NOT KNOW its cause so that we can fight it. Results have been very poor so far, despite ongoing research on the subject for more than fifty years.
Scoliosis may manifest in all ages (neonatal, infancy, childhood, adolescence); even in adult age, idiopathic scoliosis exists (resulting from neglected adolescent scoliosis). Usually, the younger the age of appearance, the more aggressive the disease course.
A 25%-30% of all patients having idiopathic scoliosis has also some family history of scoliosis.
Depending on the body area affected by it, scoliosis may be thoracic, lumbar, thoracolumbar etc.
Apart from the deformity of the back, scoliosis usually has no other symptoms, usually resulting in a late diagnosis. Medically, it can initially be detected through clinical examination, and it can subsequently be confirmed with a radiological examination. Moreover, there are advanced diagnostic methods (Laser scanner, Formetric 4D) which can greatly substitute x-rays and are indicated even during pregnancy, as they do not use any radiation.
Its treatment depends on many factors (type, deterioration rate, etc.), but mainly on the degree of spinal deformity, which is measured in degrees. When scoliosis is no more than a few degrees, it does not usually cause any pain or restrictions in movement, and it can be treated conservatively – in other words, by applying an orthopedic brace in order to stop any deterioration and at the same time correct the deformity, when this is possible.
On the contrary, when scoliosis is of many degrees, it can affect both respiratory and cardiac function. In those cases, treatment can only be done surgically.
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