Scoliosis
The Cruved Resulting Scoliosis
By Neurosurgery Singapore
What is Scoliosis?
Scoliosis is an abnormal lateral (side-to-side) curvature of the spine. While a healthy spine has natural curves at the shoulders and lower back when viewed from the side, a spine with scoliosis often appears as an “S” or “C” shape when viewed from behind.
It is important to note that scoliosis is not caused by poor posture, heavy backpacks, or vigorous physical activity. In many cases, these curves are mild, but they can become more severe as a child grows. Severe scoliosis can be disabling, as a significant spinal curve reduces the space within the chest, potentially interfering with lung and heart function.
Common Symptoms of Scoliosis
The most frequent form of this condition is Adolescent Idiopathic Scoliosis, which typically appears around age 10. “Idiopathic” means the exact cause is unknown.
Signs to Look For:
Asymmetry: One shoulder blade or hip may appear higher or more prominent than the other.
Off-center Alignment: The head may not be perfectly centered over the pelvis.
Uneven Waistline: The waist may appear tilted or uneven, causing clothes to hang improperly.
Rib Hump: When bending forward, the ribcage may appear higher on one side.
Leaning: The individual may consistently lean to one side.
Symptoms in Infants:
A visible bulge on one side of the chest.
Consistently lying in a curved position toward one side.
In rare, severe cases, shortness of breath or chest pain due to heart and lung pressure.
“Scoliosis often appears in children. In most cases, treatment is not needed, as the curve corrects itself with growth. However, based on the degree of curvature and the age of the child, a combination of bracing and physical therapy is often recommended.”
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How is Scoliosis Diagnosed?
Diagnosis begins with a comprehensive physical exam followed by specialized imaging to determine the degree of the curve.
1. Physical Examination
A specialist will observe your back while you stand to check for symmetry in the shoulders and waist. They will also perform the Adam’s Forward Bend Test, asking you to lean forward to reveal any hidden rotations or curvatures in the upper and lower back.
2. Imaging Tests
To get a precise view of the spinal structure, a doctor may request:
X-ray: The primary tool used to confirm the diagnosis and measure the degree of curvature.
MRI Scan: Uses radio waves and magnets to provide detailed images of bones and surrounding soft tissues.
CT Scan: Provides 3D cross-sectional images of the body.
Bone Scan: Uses a radioactive tracer to highlight areas of increased bone activity or abnormalities.
Comparison of Imaging Tests for Scoliosis
Choosing the right imaging test depends on what the specialist needs to see—whether it is the degree of the bone’s curve or the health of the surrounding nerves.
| Imaging Test | What It Shows | Best For… |
| X-ray | High-contrast images of the spinal bones (vertebrae). | Initial diagnosis. Measuring the “Cobb Angle” (the degree of the curve). |
| MRI Scan | Detailed images of soft tissues, nerves, and spinal cord. | Rule out complications. Checking for pinched nerves or disc issues, especially if the patient has leg pain. |
| CT Scan | 3D cross-sectional views of the bony anatomy. | Surgical planning. Providing a detailed “map” of the bone structure for a surgeon. |
| Bone Scan | Areas of increased blood flow or bone turnover. | Identifying specific issues. Finding stress fractures, infections, or small tumors that might cause a curve. |
Treatment Options for Scoliosis
Treatment depends on the severity of the curve and the age of the patient. Most mild cases do not require invasive intervention and are managed through regular monitoring.
Bracing
If a child is still growing and has a moderate curve, a specialist may recommend a back brace. While a brace cannot “cure” or reverse the curve, it is highly effective at preventing the curve from getting worse.
Effectiveness: Braces are most effective when worn day and night.
Lifestyle: Most modern braces allow children to participate in sports and daily activities.
Duration: Bracing is typically discontinued once the bones stop growing (usually 2 years after a girl starts her period or when a boy begins needing to shave daily).
Adult and Non-Operative Care
For adults with degenerative scoliosis, treatment focuses on pain management and core stability:
Physical Therapy: Exercises to strengthen the core and improve flexibility.
Medication: Over-the-counter pain relievers or, in some cases, epidural injections for nerve pain.
Short-term Bracing: Used occasionally for pain relief (though long-term use is avoided to prevent muscle weakening).
Surgical Intervention
Surgery is generally reserved for severe cases where conservative treatments have failed. It is considered when a patient experiences:
Disabling leg or back pain.
Significant spinal imbalance.
A curve that severely restricts daily functions or quality of life.
Don’t let spinal curvature limit your life. Scoliosis doesn’t just affect teenagers; it can cause significant discomfort and mobility issues for adults too. Whether you need a second opinion or a new approach to pain management, our team is here to help you regain your quality of life. [Consult Our Spine Specialist]
