Does your child have uneven shoulders, with one shoulder appearing higher than the other? Or an oddly curved spine that looks like the alphabet S? These are some of the symptoms of scoliosis, a medical condition commonly affecting children and adolescents, particularly girls.
The prevalence of scoliosis is the highest during the growth spurt years, between the ages of 9 and 15. Scoliosis also affects adults, but is less common.
In scoliosis, the normally straight spine curves from side to side due to a deformity in the bone. The deformity can be congenital, present from birth, or it can develop during the growing years. Most often, there is no known cause, and the condition is then called “idiopathic scoliosis”.
“Scoliosis is a deformity of the spine, and should not be confused with poor posture, which is generally associated with weak muscles of the spine,” says Dr Guo Changming, Senior Consultant, Department of Orthopaedic Surgery, Singapore General Hospital.
In severe cases, the rib cage may press against the lungs and heart causing complications such as:
Scoliosis cannot be overcome by correcting posture. Food, vitamin supplements and exercise programmes have also not been found to be helpful in treating the condition or halting its progression. However, scoliosis patients are advised to stay fit and active for a better prognosis.
“If patients get appropriate treatment for scoliosis at an early stage, they can go on to lead normal lives,” says Dr Guo.
“Scoliosis is not caused by carrying heavy objects, such as heavy school bags, strenuous sports, poor posture, or a lack of calcium and other nutrients in the diet,” says Dr Guo. “Though the cause of idiopathic scoliosis is by definition unknown, it may have a genetic basis since it is known to run in families.”
The treatment for scoliosis depends on the age of the patient, the severity of the spine condition, and the cause.
Most patients with idiopathic scoliosis who have a curvature that is less than 25 degrees, don’t need treatment. These patients will simply need to be observed at regular intervals of 4-6 months. Observation involves a physical examination and an X-ray.
“Children whose self-esteem is affected because of scoliosis, may need counselling support in addition to the normal treatment procedures,” says Dr Guo Changming, Senior Consultant, Department of Orthopaedic Surgery, Singapore General Hospital.
For significant cases of scoliosis, treatment options include:
One drawback of this fusion process for children is that the bones that are joined together stop growing – hence this surgical procedure is used as a last resort for children and adolescents who still have some growth years left.
“Back braces will not help patients with congenital scoliosis or those with neuromuscular scoliosis. Congenital scoliosis is also difficult to treat with surgery and may require multiple operations,” says Dr Guo.