Idiopathic Scoliosis: Sciatica Clinic

Idiopathic scoliosis means that no cause congenital or neuromuscular that created the spinal deformation has been identified. However, idiopathic scoliosis is the most common type, affecting 2% to 3% of individuals. Individuals diagnosed with an idiopathic disease or condition can be frustrated with more questions than answers, but it can still be treated in adults and kids.

Idiopathic Scoliosis

Congenital Scoliosis

• Congenital scoliosis is an abnormal curvature of the spine related to which the patient was born.
• Usually, a failure of formation or segmentation during normal development leads to the spinal condition.

Neuromuscular Scoliosis

• Individuals with neuromuscular scoliosis are usually born with neurological disorders that contribute to muscular unevenness, often resulting in the development of the condition.
• For example, individuals with cerebral palsy are born with muscular unevenness that can contribute to scoliosis development.

Who Is Affected

Anyone can develop scoliosis, but children and adults are divided into separate categories.

Children

• Children with this condition are divided into three subcategories:
• Infantile idiopathic scoliosis
• Juvenile idiopathic scoliosis
• Adolescent idiopathic scoliosis

These classifications are based on age and skeletal maturity.

• Infantile is zero to 3 years old.
• A juvenile is 3 to 10 years old.
• Adolescents are from 11 onward or when starting puberty, to the point where the skeleton fully matures.

Adults

• Idiopathic scoliosis in adults results from undiagnosed or untreated scoliosis in childhood that gradually progressed.

Causes

Research has found a genetic predisposition to developing scoliosis, as it has been found to run in families. Genetic testing has been designed to help determine the risk of developing progressive scoliosis. Theories have been presented about abnormalities that affect the nervous system. These include:

• Dysfunctions of the brain stem or equilibrium have been frequently identified in individuals with idiopathic scoliosis.
• Other theories suggest skeletal growth abnormalities or hormonal/metabolic dysfunction may contribute to the condition.
• However, determining its exact cause remains unknown.

Signs and Symptoms

Here are some things to look out for.

• The body leans to one side.
• There is an unevenness of the ribcage or hips.
• Uneven shoulders.
• Shoulder blades may protrude or stick out.
• The head is not positioned directly above the pelvis.

Diagnosis

Idiopathic scoliosis curves tend to follow predictable patterns.

• Right thoracic or middle back scoliosis
• Left thoracolumbar or mid and low-back scoliosis
• Relative thoracic hyper or hypo kyphosis

Magnetic resonance images/MRIs of the spine can show evidence of any significant abnormalities. If no other related condition is present to suggest different causes, then the idiopathic scoliosis diagnosis can be made.

Treatment

Treatment depends on the individual’s age and the degree of curvature in the spine.

• In many cases, adolescent or juvenile idiopathic scoliosis patients that have a mild curve can be treated with a brace.
• Adults could need surgical intervention, such as a fusion surgery where rods and screws are added to realign the spine and relieve the pressure on the nerves.

Chiropractor

References

Burnei, G et al. “Congenital scoliosis: an up-to-date.” Journal of medicine and life vol. 8,3 (2015): 388-97.

Clément, Jean-Luc, et al. “Relationship between thoracic hypokyphosis, lumbar lordosis and sagittal pelvic parameters in adolescent idiopathic scoliosis.” The European spine journal: official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society vol. 22,11 (2013): 2414-20. doi:10.1007/s00586-013-2852-z

Giampietro, Philip F et al. “Congenital and idiopathic scoliosis: clinical and genetic aspects.” Clinical medicine & research vol. 1,2 (2003): 125-36. doi:10.3121/cmr.1.2.125

“Scoliosis – Symptoms, Diagnosis and Treatment.” www.aans.org/Patients/Neurosurgical-Conditions-and-Treatments/Scoliosis

“Thoracic Hyperkyphosis.” Physiopedia, 2009, www.physio-pedia.com/Thoracic_Hyperkyphosis