Scoliosis
Description
Lateral curvature of the spine that may occur in the thoracic, lumbar, or thoracolumbar spinal segment, measuring greater than 10 degrees, and associated with vertebral rotation
Classified as nonstructural (flexible spinal curve, with temporary straightening when patient leans sideways) or structural (fixed deformity)
Most commonly occurs in females; typically diagnosed at puberty and throughout adolescence
Pathophysiology
Nonstructural scoliosis
Pelvic tilt is caused by unequal leg lengths, poor posture, paraspinal inflammation, acute disk disease, or head tilt associated with poor vision leading to a spinal deviation.
There’s little change in the shape of the vertebrae.
Structural scoliosis
Congenital scoliosis is usually associated with wedge vertebrae, fused ribs or vertebrae, or hemivertebrae; it may also result from trauma to the zygote or embryo.
Paralytic or musculoskeletal scoliosis develops several months after asymmetrical paralysis of the trunk muscles due to polio, cerebral palsy, or muscular dystrophy.
Idiopathic scoliosis is the most common form; it may be transmitted as an autosomal dominant or multifactorial trait.
It appears in a previously straight spine during the growing years.
A possible cause of idiopathic scoliosis is brain stem dysfunction, possibly due to a lesion of the posterior columns or the inner ear.
Occurs in three classifications:
Infantile — affects mostly male infants between birth and age 3 and causes left thoracic and right lumbar curves
Juvenile — affects both sexes between ages 4 and 10 and causes varying types of curvature
Adolescent — generally affects females between ages 10 and achievement of skeletal maturity and causes varying types of curvature
Scoliosis stops progressing when bone growth stops.
Causes
Functional, nonstructural, or postural scoliosis
Acute disk disease
Discrepancy in leg lengths
Paraspinal inflammation
Poor posture
Poor vision
Progressive or structural scoliosis
Deformity of the vertebral bodies
Rib changes
Assessment findings
Backache
Fatigue
Dyspnea
Nonstructural scoliosis
Curve of the spine disappearing when child bends at waist to touch the toes
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