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Scoliosis is a disorder where the spine twists or curves to one side. This results in an unnatural and unbalanced appearance in the back. When the curvature becomes extreme, it can cause the patient significant fatigue and pain.

In general, scoliosis displays no obvious symptoms at first, but rather is often first observed through secondary signs, such as having shoulders of unequal height, a chest or back protruding disproportionately, or uneven hips. However it appears though, scoliosis with significant pain must receive a thorough examination in order to ascertain the root cause.

Scoliosis is classified into different types according to these various causes:

Congenital scoliosis develops while the baby is still in the womb, during the initial growth of the spine. The usual manner of identifying this form is to x-ray the infant’s spine to observe whether some vertebrae are congenitally abnormal.

Neuromuscular scoliosis occurs in children who have abnormal development of the brain. Their disorder of the nervous system causes the muscles around the spine to contract unequally, thus pulling the vertebrae out of alignment. The patient, if unable to walk, must sit in a wheelchair, and if unable to do that, must live their life in bed. In cases such as this, the child will often have various other abnormalities, such as weak muscles, stunted muscle growth, and/or respiratory issues.

Idiopathic scoliosis is the most common form, often encountered in adolescents who appear otherwise normal. This diagnosis is determined when after a thorough examination of the body and spine, no obvious reason can be found to explain the origin of the curvature.

scoliosis2Another form not mentioned before, though often found, would be called “mild scoliosis,” which as its name suggests, is only a mild distortion of the spine, but yet does not seem to disappear of its own accord. Treatment in these cases intends to limit further misalignment and if possible, to realign the spine to a more normal posture. The majority of cases of scoliosis found are like this, with neither a clear cause nor any immediate danger to the patient. The only distressing side-effect in such cases would be the effect on their cosmetic appearance.

However in cases where the spine curves significantly (sometimes even up to the point of 90 degrees), the patient may often experience fatigue. This occurs due to the narrowing of the chest, which, putting pressure on the lungs, prevents them from expanding fully.

As for scoliosis in its congenital form, there is a serious risk from other congenital abnormalities of the heart and of the urinary system. In order to prevent such dangerous effects, measures must be taken to prevent further curvature and to remedy the existing misalignment. However, with all these forms, the case for each patient is different. It all depends on the severity of the curvature, the age of the patient, and the secondary symptoms caused by the disorder. After a certain diagnosis can be made, treatment thus follows the guidance of a doctor.

Scoliosis most often occurs in those with a family history of the disease. The majority of cases indeed have no known cause, often beginning in adolescents aged about 10 – 14 years. Treatment will have a positive outcome if the curvature is discovered while still mild. Doctors who care for this disease are specialists in skeletal disorders (known as orthopaedics) or specialists in children’s skeletal disorders (known as pediatric orthopaedics).

By Amnuay Jirasrikun, M.D. Orthopaedic Surgeon

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