Scoliosis: Understanding Spinal Curvature and Its Treatments

What is scoliosis?

Scoliosis Idiopathic is the lateral deviation of the spine, in a previously healthy child, without knowing the cause that produces it. The deformity is observed when we perform one of the child seen from the front, but the deformity is three-dimensional, with significant rotation of the vertebrae that make up the spine.

Idiopathic scoliosis is classified into three types:

• Infant: appears before three years and even before 6 months of life. Most of them resolve on their own but a minority suffer from progressive deterioration.
• Juvenile: appears between 3 and 10 years.
• Adolescent: appears in those over 10 years of age.

It is not included within the scoliosis idiopathic curves formed by having one leg shorter than the other; in this case, when correcting and equalizing the length of the legs, the curve disappears.

Cause

As it is called "idiopathic" it means that it is not known what causes it. Despite this, it seems that genetics and growth play a role. Children of parents who have scoliosis are at higher risk of developing it. During childhood there are two periods of accelerated growth: from birth to two years and the prepubertal period. It is more common in girls.

It can affect any area of ​​the spine, although it most often affects the thoracic region. Double curvatures are very common.

All curves of the spine due to scoliosis have other so-called compensatory curves that are above or below the main curve. Its function is to balance the head on the pelvis.

Scoliosis treatment

The purpose of the treatment is to ensure that at the end of bone growth the deformity is moderate and that it does not cause restriction of daily activities and does not exceed 45-50º.

The type of treatment depends on the degree of deformity, the age of the child and the degree of bone maturity.

Below 20º radiological controls are carried out every 3-6 months until bone maturation is complete.

If from 25-30º the child has very little bone maturation, he is at risk of worsening, so a corset will be placed to stop the evolution of the deformation. If diagnosed when the bone is mature (girls older than 13-14 years and boys older than 15-16), a brace is not placed because the curve will not evolve significantly. The corset should be worn 23 hours a day if the child has poor bone maturation. If the bones are more mature, it should be worn 16 hours a day (especially at night).

There are different types of corset depending on the age and the type of deformity.

Corrective surgery is indicated in curves greater than 45-50º. It aims to minimize the curve and fix the vertebrae in the best possible position.