SCOLIOSIS

A scoliosis is a lateral or sideways curve in the spine that is apparent when viewing the spine from behind. A mild degree of scoliosis is common, occurring in up to 50 per cent of the population. Scoliosis occurs mainly in the thoracic and thoraco-lumbar regions of the spine and is far more common in females.

There can be many causes of a scoliosis, but by far the most common is the unknown, or idiopathic. Curvature can develop at any age but rapid acceleration of the curve develops around puberty. Adolescents around the age 9 – 14 are the most common age group affected. Genetic inheritance may be a major contributor to a scoliosis.

The best way to look for a scoliosis is to look at the back from behind as the person bends forward. It is easy to see the curve as one side of the rib cage will project more than the other. If there is a suggestion of a scoliosis medical opinion should be sought. Plain x-rays of the spine can easily detect the extent of a scoliosis.

The most important part of the management of scoliosis is early detection; this may prevent the need for surgery. The management of a scoliosis is determined by its extent. In the majority of cases a mild scoliosis requires no specific treatment.

Physiotherapy intervention plays an important role in the management of scoliosis.

Treatment may consist of:

• Postural correction and advice
• Strengthening of muscles and correction of muscle imbalance through the use of exercise including Pilates
• Strapping or taping

In more severe cases bracing may be necessary, and may prevent the need for surgery.

In the most severe cases, surgery may be indicated. This involves insertion of metal rods along the spine. These rods act as a brace to straighten the spine and prevent further deterioration of the scoliosis. The rods are usually left in the spine throughout life. Life after surgery returns to near normal by about 9 months.

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