Scoliosis
Definition
- Scoliosis is a sideways curvature of the spine that most often is diagnosed in
adolescents
- Viewed from the side, the normal spine takes the form of an elongated S, the upper
back bowing outward and the lower back curving slightly inward. Viewed from behind
though, the spine should appear as a straight line from the base of the neck to the
tailbone
- When people with scoliosis bend over a gibbus may be seen
- There are 3 main types of scoliosis
o Idiopathic scoliosis
▪ Early onset
• Infantile (1-3 years of age)
o Associated findings are mental deficiency, congenital hip
dislocation, plagiocephaly (= flattening of one side of the
skull), congenital heart defects
o 90% spontaneously resolve, but some curves may be
progressive (malignant progressive is from 10 degrees
or more per year)
• Juvenile (3-10 years of age)
▪ Late onset (adult)
• Polygenetic interaction is suspected
• Risk progression is related to curve size and skeletal growth
• Female to male ratio is 10:1 for curves > 30 degrees
o Congenital scoliosis:
▪ Failure of formation of vertebrae
▪ Failure of segmentation of vertebrae
o Neuromuscular scoliosis
@MyMedicalPulse 1
, Figure 1: Adapted from Lecture Scoliosis by Prof. Lodewijk van Rhijn
Epidemiology
- It affects 2-3% of the population
- Primary age of onset is 10-15 years old, but it can also develop in infancy or childhood
- Although both boys and girls develop mild scoliosis at about the same rate, girls have
a much higher risk of the curve worsening and requiring treatment
Causes and risk factors
It’s not known what the cause is of scoliosis, but hereditary factors seem to be involved, since
the disorder sometimes runs in families. Less common types of scoliosis may be caused by:
- Certain neuromuscular conditions, such as cerebral palsy or muscular dystrophy
- Birth defects affecting the development of the bones of the spine
- Previous surgery on the chest wall as a baby
- Injuries to or infections of the spine
- Spinal cord abnormalities
Risk factors include:
- Age: signs and symptoms can begin at early age or at adolescence
- Gender: girls have a much higher risk of curve worsening and requiring treatment
- Family history
In congenital scoliosis, the main cause is failure of formation or segmentation of the
vertebrae, which leads to vertebrae looking like the figure below.
Figure 2: Adapted from Lecture Scoliosis by Prof. Lodewijk van Rhijn
@MyMedicalPulse 2
Definition
- Scoliosis is a sideways curvature of the spine that most often is diagnosed in
adolescents
- Viewed from the side, the normal spine takes the form of an elongated S, the upper
back bowing outward and the lower back curving slightly inward. Viewed from behind
though, the spine should appear as a straight line from the base of the neck to the
tailbone
- When people with scoliosis bend over a gibbus may be seen
- There are 3 main types of scoliosis
o Idiopathic scoliosis
▪ Early onset
• Infantile (1-3 years of age)
o Associated findings are mental deficiency, congenital hip
dislocation, plagiocephaly (= flattening of one side of the
skull), congenital heart defects
o 90% spontaneously resolve, but some curves may be
progressive (malignant progressive is from 10 degrees
or more per year)
• Juvenile (3-10 years of age)
▪ Late onset (adult)
• Polygenetic interaction is suspected
• Risk progression is related to curve size and skeletal growth
• Female to male ratio is 10:1 for curves > 30 degrees
o Congenital scoliosis:
▪ Failure of formation of vertebrae
▪ Failure of segmentation of vertebrae
o Neuromuscular scoliosis
@MyMedicalPulse 1
, Figure 1: Adapted from Lecture Scoliosis by Prof. Lodewijk van Rhijn
Epidemiology
- It affects 2-3% of the population
- Primary age of onset is 10-15 years old, but it can also develop in infancy or childhood
- Although both boys and girls develop mild scoliosis at about the same rate, girls have
a much higher risk of the curve worsening and requiring treatment
Causes and risk factors
It’s not known what the cause is of scoliosis, but hereditary factors seem to be involved, since
the disorder sometimes runs in families. Less common types of scoliosis may be caused by:
- Certain neuromuscular conditions, such as cerebral palsy or muscular dystrophy
- Birth defects affecting the development of the bones of the spine
- Previous surgery on the chest wall as a baby
- Injuries to or infections of the spine
- Spinal cord abnormalities
Risk factors include:
- Age: signs and symptoms can begin at early age or at adolescence
- Gender: girls have a much higher risk of curve worsening and requiring treatment
- Family history
In congenital scoliosis, the main cause is failure of formation or segmentation of the
vertebrae, which leads to vertebrae looking like the figure below.
Figure 2: Adapted from Lecture Scoliosis by Prof. Lodewijk van Rhijn
@MyMedicalPulse 2
