Scoliosis: Symptoms, Causes, Treatment

In scoliosis (synonyms: Activated scoliosis; cervical spine scoliosis; lumbar spine scoliosis; acquired scoliosis; idiopathic scoliosis; juvenile scoliosis; kyphoscoliosis; lumbar spine scoliosis; left convex cervical spine scoliosis; lumbar scoliosis; lumbar torsion scoliosis; Paralytic scoliosis; S-shaped lumbar spine scoliosis; Secondary scoliosis; Spinal scoliosis; Torsion scoliosis; WS scoliosis; Adolescent scoliosis; Thoracolumbar scoliosis; Thoracic scoliosis; ICD-10 M41. -: Scoliosis) is a lateral curvature of the body axis. In most cases, this refers to the lateral curvature of the spine, which is caused by an asymmetry of the individual components of the spine. In addition to this, the vertebral bodies are twisted.

Scoliosis can be congenital (congenital) and acquired.

Orientational radiographic examination allows classification into:

  • Functional scoliosis – frontal spinal curvature in which no structural or shape changes are detectable in the radiograph.
  • Structural scoliosis – fixed, not reversible; can not be sufficiently corrected either actively or passively.

In addition to these two forms, there is idiopathic scoliosis, which represents the most common type of disease (about 90% of all scolioses in the growing age). In this form, the exact cause is unclear.

Idiopathic scoliosis is divided into:

  • Infantile scoliosis (<3 years of age) – diagnosed before the age of 4 (approximately 1%).
  • Juvenile scoliosis (3 to 9 years) – diagnosed by the age of 10 (about 9%).
  • Dominant adolescent scoliosis (synonym: adolescent scoliosis) (10 to 18 years) – is diagnosed only from the age of 10.
  • Adult degenerative scoliosis (ADS; synonyms: adult or degenerative scoliosis; adult scoliosis).

Scolioses are categorized by onset:

  • <10 years “early-onset scolioses” (EOS; defined as spinal curvature of any etiology) – unfavorable progression tendency.
  • ≥ 10 years of “late-onset scolioses”

Most idiopathic scolioses are located in the thoracic region and are right convex.

Furthermore, there are the following special forms of scoliosis:

  • Static scoliosis (e.g., in leg length discrepancy).
  • Pain scoliosis (e.g., in herniated disc).

According to the localization of scoliosis, the following classification can be made:

Sex ratio: boys to girls is 1: 4-7.

Frequency peak: the maximum occurrence of idiopathic scoliosis is just before or at puberty.

The prevalence (disease incidence) is 3% in children. In school children, the prevalence is 1-2% and increases to over 8% in adults beyond the age of 25 (in Germany). Worldwide, the prevalence is 1.1%. In Germany, approximately 400,000 people suffer from scoliosis.

Course and prognosis: Infantile sclerosis is usually diagnosed from the 6th month of life. They correct spontaneously (by themselves) in 85-90% of cases and do not require therapy. Only the remaining, progressive (advancing) scolioses often require therapy. Scolioses worsen during periods of growth, such as during puberty, so prognosis depends on what is called growth reserve (growth yet to occur) at the time the scoliosis is diagnosed.