5 points about scoliosis
What is scoliosis ?
The human spine is made up of 24 mobile vertebrae. Stacked one on top of the other, they form the spinal column.
When viewed from the side, the spine presents curvatures in different directions: cervical or lumbar kyphosis or lordosis. These curvatures are known as physiological. Their role is to ensure the anterior-posterior balance of the trunk. But an increase in one or more of these curvatures can be caused by disease. The curvature is then said to be pathological. Any lateral deviation of the spine is called scoliosis. It causes an asymmetry of the trunk, noticeable in the standing position at the neck line, shoulders, shoulder blades and waist. Scoliosis is not a disease per se, but a symptom triggered by a variety of causes.
Are there different types of scoliosis?
Yes, there are many.
First and foremost, it’s important to distinguish scoliosis from structural scoliosis. Only the latter are pathological. Structural scoliosis is lateral deviation of the spine, with deformation of all its components: vertebrae, discs and ligaments. They persist in the supine position and evolve in all 3 planes of space, creating a veritable torsion of the spine. Three-dimensional thoracic deformity can have severe respiratory consequences.
A key clinical sign in the diagnosis of structural scoliosis is the lateral hump, or gibbosity. It’s a sign that all parents should be aware of and look for periodically.
What causes structural scoliosis?
For some, the cause is obvious. In the case of congenital anomalies, for example, the diagnosis can be clearly established by radiological examination at birth. In other cases, scoliosis appears as part of the evolution of a well-known disease. It is then one of its clinical signs. For example, bone, neuromuscular, connective tissue or metabolic diseases.
But in 70% of cases, scoliosis is the only apparent sign of the disease. This is known as idiopathic scoliosis. Torsion is the only known manifestation. The diagnosis can only be made by elimination. It affects nearly 5‰ of school-age children.
How will idiopathic scoliosis develop?
Some scoliosis will worsen steadily, others will remain stable, and still others will regress spontaneously. Radiographic examination is essential.
Bone age, in particular, is a key prognostic factor in assessing the risk of worsening. What’s more, the earlier scoliosis appears, the more likely it is to progress. Infantile forms, discovered before 3 years of bone age, are most often progressive and particularly dreadful.
Juvenile forms appear between the age of 3 and puberty. They do not all progress with the same rapidity or severity, but puberty is always a high-risk period. This form of scoliosis affects 80% of girls.
Adolescent scoliosis, which occurs after puberty, is usually less severe and usually stabilizes.
In adulthood, particularly in old age, the scoliotic spine can deteriorate severely, causing severe pain and discomfort.
Idiopathic scoliosis remains a vast field of investigation
So many questions remain!
What causes scoliosis?
Why is scoliosis more common in girls than in boys?
What determines its location? Why are some more progressive than others?
Are there other, currently unknown, associated anomalies?
Do balance centers play a role? How can scoliosis be prevented and treated?
