FAQ on Curved Spines (Scoliosis)

by Dr. Y.L.M

My little girl was born normal, but when she turned 7, she suddenly developed a curved spine. I am very worried. Will she grow out of it?

The term for an abnormal or exaggerated sideways curvature of the spine is called scoliosis. Your normal spine usually has curves when you are looking at it from the side.

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But if you look at the skeleton from the back, the spine should not have any curves and should appear straight. Scoliosis is what happens when the spine curves sideways, and the bones then twist upon each other like a corkscrew. This is to be differentiated from kyphosis (hunchback), where the spine is abnormally bent forward, more than usual. If the spine is abnormally bent backward, this is called lordosis.

As to whether your girl will grow out of it remains very subjective, but it is highly unlikely. The basic rule is – the more growth the patient has remaining, the more likely the scoliosis will get worse.

At 7, your little girl has still quite a lot of growing up to do.

But is scoliosis common in children? At so young an age?

Scoliosis can actually occur at any age, but it is more common in people over 10 years old. It is twice as common in girls than boys.

If your child is below 3 years old and develops scoliosis, this is called infantile idiopathic scoliosis.

If your child is between 3 and 10 years of age when she first develops scoliosis, this is called juvenile idiopathic scoliosis. If your child is over 10 years of age, this is called adolescent idiopathic scoliosis.

What does idiopathic mean?

It means the cause is unknown or uncertain. But scoliosis is known to be hereditary. If you have scoliosis, your children are also more likely to have scoliosis.

It is just that if you have mild scoliosis, there is no guarantee that your child – if she develops scoliosis – will also have mild scoliosis. The severity of scoliosis can not be predicted from generation to generation.

But there are types of scoliosis where the cause is known. These include :

* Functional scoliosis – your spine is normal, but because you have a disorder somewhere else in the body, such as if one of your legs is shorter than the other, or if you have muscle spasms in your back, your spine then curves abnormally to compensate for it.

* Neuromuscular scoliosis – this severe type of scoliosis develops before birth, when the bones are starting to form in the foetus. It is usually associated with other birth defects like cerebral palsy, muscular dystrophy, and Marfan's disease. If the scoliosis is present when your baby is born, then it is termed congenital.

* Degenerative scoliosis – this one occurs in older adults, due to arthritis. When you get older, some of your ligaments and muscles around the spine weaken and can no longer hold your spine in its posture.

My little girl says her scoliosis does not hurt her. But some of her schoolmates are laughing at her. Will her scoliosis begin to hurt her in the near future?

Most cases of scoliosis do not cause pain, and the only complaint is the abnormal curvature of your spine, which can cause your head to appear tilted, or one of your hips or shoulders to be higher than the other. Sometimes, it is so mild that everyone does not notice it until subtle things like not fitting into your school uniform begin to surface.

Severe scoliosis, however, can cause problems for your rib cage. Your lungs and heart may not be able to function properly and you may have breathing difficulties.

Some types of scoliosis can cause back pain.

Can scoliosis be treated?

Definitely. The treatment of scoliosis varies from type to type and severity. The treatment of idiopathic scoliosis, such as the type your child is likely to have, is based on the age when it develops.

Your child is 7 years old, so she is likely to have juvenile idiopathic scoliosis, which unfortunately has the highest risk of getting worse (compared with all the idiopathic types of scoliosis).

If your child's abnormal curvature is not too severe, we can try bracing first. There are also many types of braces. Some braces need to be worn 24 hours a day and are removed only when you bathe.

Some braces are worn only at night. Braces do not correct the scoliosis, but they can help slow down the curvature.

Now, if your child's curve stays below 40 degrees until she has finished growing, it is not likely to get worse when she is an adult. But if the curve is greater than 40 degrees, it is likely to get worse, and one day, she will be at risk of heart and lung problems.

If bracing fails, surgical intervention is needed. Certain parts of bones might need to be removed or the spine might have to be fused.

It is difficult and you will not be able to bend normally for the rest of your life, but at least you will be able to breathe properly and have as normal a life as possible.

Other types of scoliosis, like functional scoliosis, can be corrected by addressing the root cause, such as a shortened leg.

More info on CURVED SPINE here.

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