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Scoliosis

Scoliosis is a spinal condition whose cause is often unknown. For certain cases, it occurs as a side effect of a disease, such as cerebral palsy or muscular dystrophy, or from an infectious disease of the spine.
Symptoms of scoliosis can be mild or severe. Children born with scoliosis can experience spinal deformities as they reach adolescence.  

What is Scoliosis?
โรคกระดูกสันหลังคด คืออะไร
 

Normally, our spines are supposed to be aligned straight vertically. People suffering from scoliosis, however, have a spine that curves either slightly or severely, in the shape of a “C,” or in the shape of an “S.” Curvatures can lean towards the right or the left side.
 
Many cases of scoliosis have no known cause — collectively known as idiopathic scoliosis. If the scoliosis occurs as a result of genetics, it is broken down and categorized based on the patient’s symptoms, as follows:   
 
สาเหตุของโรคกระดูกสันหลังคด
  • Infantile Idiopathic Scoliosis – Scoliosis with no known cause developing before age 3
  • Juvenile Idiopathic Scoliosis (JIS) – Scoliosis with no known cause developing between ages 4-10
  • Adolescent Idiopathic Scoliosis (AIS) – Scoliosis with no known cause developing between ages 10-18. This type is the most common type.
Scoliosis can also be broken down as follows:
  • Congenital Scoliosis – Scoliosis that develops while in the womb
  • Functional Scoliosis – Scoliosis during childhood that develops as a result of some other physical issue, such as uneven leg length, muscle shrinkage, or the result of an accident or activities that promote repeated uneven balance
  • Neuromuscular Scoliosis – Scoliosis resulting from a brain or spinal cord disorder, in which the nerves and muscles are unable to maintain an appropriate alignment of the spine 
  • Degenerative Lumbar Scoliosis – Scoliosis that occurs in older adults due to prolonged pressure and load on the spine over time
Symptoms of scoliosis may include:
  • Uneven shoulders / high shoulder blades (scapulas)
  • Uneven waist
  • Uneven hips
If symptoms intensify, apart from a spinal curvature that leans towards the left or right side of the body, the spinal cord may even bend forward or backward as well as develop a spinal rotation (twisting of the spine).
อาการของโรคกระดูกสันหลังคด
The doctor will perform a thorough review of the patient’s medical history alongside the physical examination. The physical examination involves examining the spine, both front and back; the patient will lean forward and touch their toes to see whether each side of the back is normally aligned, as well as if the shoulders, hips, and waist are even. The doctor may also require an X-ray to look for any abnormalities of the spine and if there are any issues affecting the nerves.

The doctor may also ask to perform an MRI for further analysis if a problem is suspected.
Common risk factors for scoliosis include:
  • Age – The onset of scoliosis most often occurs in childhood before adolescence
  • Sex – Both boys and girls have the same chance of developing scoliosis; however, girls are more likely to experience more severe symptoms
  • Family history – Although most cases of scoliosis involve no family history of the condition, genetics can be the cause in some cases
Even if symptoms are not severe, possible side effects of scoliosis include:
  • Lungs and heart not fully functioning This may occur in cases of severe scoliosis where there is severe deformity of the spine, sometimes occurring with a deformity of the hips as well — which affects heart and lung function, causing the patient to feel fatigued more than usual
  • Back problems – People with scoliosis as a child have a higher risk of experiencing back pain later in life
  • Unusual appearance As the condition progresses, symptoms will become increasingly noticeable. For example, the shoulders and hips become increasingly uneven, and/or the rib cage protrudes. Additionally, these symptoms can all cause emotional distress
A treatment plan is determined after the doctor comes to a diagnosis; treatment may include:
  • Back braceSome patients may be required to wear a back brace to correct the spinal curvature. However, this method may not be suitable for young patients who are still growing. The back brace is designed to slow the progression of the curvature. Patients will generally be required to wear the brace at all times except during exercise or bathing.
Some patients may wear the brace only when sleeping. These braces are usually only used by people with 25-40 degrees’ curvature. People with curvatures of 40-50 degrees may also wear a back brace but are generally advised to undergo surgery.
  • Scoliosis surgery – The doctor may recommend that patients undergo surgery if all other treatment methods have proved unsuccessful or if the scoliosis is so severe that surgery is the only suitable option.
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