Scoliosis is a common condition, but most people are often unaware or do not realize it beforehand because approximately 80% of cases are idiopathic scoliosis, and only 20% are congenital abnormalities or scoliosis associated with other diseases. Currently, treatment advances have greatly improved. If detected and treated at the appropriate time, along with cooperation from the patient and family members, the spine can be restored to a near-normal state.
What is scoliosis?
Idiopathic scoliosis involves curvature combined with rotation of the spine. On anteroposterior spinal X-rays, the curvature angle (Cobb angle) is greater than 10 degrees. Scoliosis can be broadly classified into:
- Idiopathic scoliosis, which is further divided by age group. In patients aged 10-15 years with scoliosis, it is believed that up to 10% is inherited genetically.
- Congenital scoliosis, caused by incomplete formation of vertebral bones.
- Scoliosis associated with other diseases, such as neuromuscular disorders or syndromes like Down syndrome.
How to know if you have scoliosis?
- Physical examination: Have the patient stand straight. Signs that may indicate scoliosis include:
- Unequal shoulder height
- Unequal prominence of the shoulder blades
- Unequal hip alignment
- Body leaning to one side
- In females, breast size asymmetry may be observed
- Adam’s forward bending test: Have the patient stand with feet together and bend forward, touching the floor with both hands. Unequal prominence of the back (rib hump) can be seen.
- Additional examinations: Other system examinations to identify suspected associated diseases. Radiographic imaging may be required. If other abnormalities are suspected, further imaging such as CT, MRI, or laboratory tests may be necessary.
Non-surgical treatment of scoliosis
- The doctor will explain the condition of scoliosis and its progression to the patient and relatives, and help monitor changes in spinal curvature continuously.
- Non-surgical treatment is used for patients with mild curvature, no imbalance (no significant trunk lean), and no neurological abnormalities.
- Treatment involves wearing a brace to prevent further curvature. The brace should be worn about 23 hours a day, except when bathing.
- The brace must be worn until the child stops growing, then gradually reduce the wearing time until it is certain that the curvature does not worsen, then stop wearing it. For patients near or at growth completion, the brace is no longer beneficial.
Surgical treatment of scoliosis
The choice of surgical method depends on several factors, such as the flexibility or severity of the spinal curvature, the number of affected vertebrae, and the location of the curve. Discussion with the patient and family members is necessary to ensure mutual understanding of the surgical goals.
The surgical principles include bone reshaping, muscle and joint dissection to increase flexibility, and insertion of rods to support the spine into the desired alignment. The surgeon’s expertise, experience, and familiarity with the procedure are crucial to restore the spine as close to normal as possible.
Scoliosis can be treated to return to near-normal condition if treated properly and at the appropriate time.
