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Scoliosis means "curvature or bending of spine". This can occur due to many reasons, the main ones are

  • Idiopathic - the most common one. The word Idiopathic is very commonly used to indicate any disease - the exact cause of which is not known to medical science.
  • Congenital - Congenital Scoliosis occurs due to improper formation of the bone of the spine during pregnancy, leading to bending, as the child grows older. There are many varieties in this category and the severity varies with the area of spine affected.
  • Neuromuscular - this occurs in children with Nerve and Muscle Diseases. Even though the exact cause is not known, it is commonly believed to be due to improper muscle co-ordination, leading to poor support of the spine and the spine bends. It is more commonly seen in children who are wheelchair bound, in diseases like Cerebral Palsy, Muscular Dystrophy etc.
  • Spinal Cord Formation Problems - Several spinal cord diseases like Syringomyelia (fluid collection inside the spinal cord), Spinal Bifida (Splitting of the spinal cord due to improper formation during pregnancy) can cause scoliosis. This requires careful clinical examination as the cause may not be very evident initially.
  • Genetic Orthopaedic Diseases involving muscle and ligament
  • Several Genetic Syndrome

Idiopathic Scoliosis:

The most common variety of scoliosis, it is found in three groups based on the age that it is observed in.

  • Early Onset (less than 6 years)
  • Juvenile (about 9 years)
  • Adolescent (Adolescent age group)

In general, scoliosis is more common in females than in males. During the early stages, parents most often don't notice the curve as it could be hidden under loose clothes and by the time the patient checks with the doctor, it has progressed and the curve is big. It then becomes difficult to control the curved spine by using non operative methods like braces.

There have been attempts to detect the curve early in developed countries by using school screening programs. Unfortunately, the cost effectiveness of such a program is still debated as the disease is not so common and many mild curves that may not require treatment get over treated.

Authored By : DR. DAVID V RAJAN

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