Understanding Scoliosis

Scoliosis Defined:

Scoliosis is the most common spinal disorder in children and adolescents. A scoliosis is defined as a disease of the neuromuscular skeletal system, presenting with a lateral curvature of the spine greater than 10°, usually combined with a rotation of the vertebrae and most often a reduced kyphosis in thoracic curve. While scoliosis can be caused from conditions such as Cerebral palsy and muscular dystrophy, the etiology of scoliosis is still unknown.  [1]

Prevalence:

Adolescent idiopathic scoliosis is a common disease with an overall prevalence of roughly 5 % in the current literature. The female to male ratio ranges from 1.5:1 to 3:1 and increases substantially with increasing age. A three year study out of Brigham Young University with over 3,000 college age women showed that 12% of them presented with scoliosis. The study also showed how the traditional Adam’s forward bending test was ineffective at detecting early stages of AIS.

Dr. BJ Palmer, had the second largest osteological collection of spines in the world. He hypothesized that scoliosis is prevalent in 20-30 percent of the population.

Common Alignment Abnormalities:  

  1. A bend in the spine.  This is typical seen as one is bending over, making the spine and the ribs more prominent.
  2. Unlevel shoulders or hips.
  3. A short leg
  4. A loss of the normal curves of the spine in the sagittal plane (side view). This could be noting excessive slouching when sitting, or excessive forward head posture (when the head lays in front of the shoulders).

Types of Scoliosis:

Although existing since time began, the causes of scoliosis are generally unknown.  The National Health Service states that 80% of scoliosis has no known cause, or is idiopathic. Based upon the patient’s age and when the diagnosis took place, there are 4types of scoliosis.

  1. Infantile Idiopathic Scoliosis: This is when the diagnosis was present from birth – 3years of age.
  2. Juvenile Idiopathic Scoliosis: This is diagnosed from age 3-10
  3. Adolescent Idiopathic Scoliosis: This occurs from the age of 10- until the growth spurt or puberty is complete.
  4. Adult Idiopathic Scoliosis: This type of scoliosis often starts with a small curve druing the teenage years that progressed sometime after skeletal maturity.

WHY YOU?

The main CAUSES of scoliosis:

  1. Nervous System Stress, Tension or Irritation
    Scoliosis caused from Nervous system stress or tension is a situation where there is either a tight, inelastic, or tethered spinal cord. The nerve roots or meninges are the main initiating factor causing the spine to rotate down into double helix type of shape like in DNA. Nervous System Tension is likely the most common root cause of scoliosis in general. If there is rapid progression of one’s scoliosis, and has been deemed idiopathic, then most likely it has some sort of nervous system tension as the primary cause.Scoliosis caused from nervous system tension is the body’s way of adapting to its environment. Surrounding the spinal cord is a sock like covering called the meninges. The meninges have diagonal fibers, and when tension is on the spinal cord or nerves, that in turn stretches and pinches down on the spinal cord and nervous system in that area.  Nervous system tension can happen from the spinal bones out growing the spinal cord, resulting in stretching of the cord, from a tethered spinal cord; a condition from birth which causes the entire spinal cord to be pulled noticeably lower, or a loss of the structural integrity of the spine.
  1. Structural Causes
    Structural causes of scoliosis are very common and only cause a mild to moderate non-progressive curves. An example of a structural scoliosis would be due to something called a “Hemi-Vertebrae”.  A hemi-vertebrae is when one or more of the vertebrae are asymmetrically formed from birth. This causes the spine to grow and progress on an unstable foundation, resulting in a structural scoliosis.

Another example is when one leg grows a little longer than the other. With the sacrum bring the base of the spine, this causes it to become unlevel, so when the sacrum tilts the spine will tilt with it. As a result, a mild and sometimes moderate scoliosis can be the result.

Ligament damage or laxity from trauma, degeneration, or even the birthing process can also be a key contributor to structural scoliosis.  If main stabilizing ligaments of the spine have become damaged or torn, the vertebra may become unstable and tilt in response, creating a scoliotic curve.

  1. Pathological Causes
    In these conditions, there is a breakdown either in the body’s control system (the brain) or the nerves that connect the brain to the muscles, or the muscles themselves cannot work correctly.

Examples:

  • Cerebral Palsy
  • Poliomyelitis
  • Muscular dystrophy
  • Severe chiari and syringomyelia
  • Functional neurologic deficits
  • Muscular atrophy