Conditions / Diagnoses

Scoliosis is a curvature of the spine. In juvenile scoliosis, the majority of the curve occurs during a child's growth spurt. Adult scoliosis occurs when the spine begins to curve as a result of disc and facet joint degeneration, an injury, or thin bones otherwise known as osteoporosis. When degenerative scoliosis is severe, corrective surgery may be indicated. If degeneration worsens, the nerve roots that originate in the spinal cord and exit, going toward the legs, can become compressed. This condition is called a radiculopathy or abnormality of the nerve roots. If the spinal canal or nerve roots in the back of the vertebrae become small enough to cause nerve root compression, it is called stenosis, which can lead to pain or weakness in the legs and problems with the bowel and bladder.

Symptoms: Scoliosis is usually not painful. The curvature may be noticed by a family member as the wing of the shoulder may "protrude" more on one side, or one shoulder may be higher or lower than the other.

Diagnosis: Once the curvature begins, a doctor may recommend routine x-rays to measure the curvature. The measurement can help the doctor make a treatment decision. If the scoliosis is painful, the doctor may recommend special x-rays or an MRI to help find the cause of the pain.

Treatment: In adult cases, initial treatment may include pain medication and treatment of the thin bones (osteoporosis). It may also include an epidural corticosteroid injection. Making the bones stronger may prevent the curvature from worsening. If it worsens, as in adolescent idiopathic scoliosis, bracing may be prescribed. If the brace does not work and the curvature continues to worsen, thoracic scoliosis surgery can straighten the spine or prevent the curvature from becoming any worse. Surgical treatment may include making more room for the nerves that exit the spine. Physical therapy may also be recommended for scoliosis patients.