Scoliosis is a three dimensional deformity of the spine. The lordosis or arched spine is combined with rotation and lateral bending. The spinous process deviates to the concave side bend. Idiopathic scoliosis accounts for 80% of cases. There are many initiating factors which cause uneven progress of epiphysial growth plates.
Infantile scoliosis occurs in children up to 3 years and is more common in boys. Adolescent type is more common in girls (95%) Progression of the curve is also more common in girls. Adolescent type scoliosis occurs between the age of 10 and spinal maturity. With spinal maturity the grown plates fuse and growth ceases. This occurs at 16-17yrs for females and 17-18yrs for males. Curves of less than 30° rarely progress after spinal maturity; those above 30° progress at 1° a year. Growth spurts in adolescence may demonstrate rapid curve acceleration. Changing bone chemistry with ageing and menopause can produce altered stress on spinal segments and increase pain from a scoliosis previously asymptomatic.
Postural and some idiopathic scoliosis can be treated with manual techniques and muscle balance. Early and regular evaluation is essential. Torsion of the ribs may cause breathing problems. Rapidly developing scoliosis in adolescence needs careful evaluation and may require surgical fixation with spinal rods.
Adolescents between the ages of 10-18 should be regularly observed for any spinal deformities, especially girls in whom pregression of a curve is much more likely. Medical advice should be sort from a specialist in the field if there are any doubts. Early diagnosis and treatment are essential.