Introduction
Scoliosis is a sideways curvature of the spine. The term scoliosis comes from the Greek word 'skolios', which means curved or bent.
There are two forms of scoliosis, postural and structural.
- a postural scoliosis is a curve that is due to not standing up straight due to pain, unequal leg lengths or slouching. A postural scoliosis can be self-corrected
- a structural scoliosis is a curve that bends to the side, and also rotates on its vertical axis. These curves often have cosmetic and physiological changes that can have long-term effects. A structural scoliosis does not self-correct
Signs and symptoms
Scoliosis may appear as
- one shoulder higher
- rib asymmetry
- deeper waist on one side
- one hip more prominent
- uneven shoulder blades
- trunk shift to the side.
Diagnosis
Your child’s doctor will be able to make a diagnosis, based on your child's signs and symptoms and/or after any appropriate tests.
Treatment
Casting
In young children, under 6 years of age, a plaster cast can be put on under a general anaesthetic to help push the spine straight. The cast is worn for about 6 weeks before it is removed. Some children may need several casts one after another.
Orthoses
A thoraco-lumbo-sacral orthosis (TLSO) is a medical device that is designed to push on the body to prevent the curve from getting worse while your child is still growing. A TLSO is sometimes called a brace and is suitable for curves with an angle of 20-40o.
A TSLO is usually made from plastic, and is worn under clothes for 16-20 hours per day. There are many types of TLSO and the style will depend on a thorough assessment of your child and their curve.
Surgery
For curves where a TLSO is not suitable, your child may need surgery to stabilise the curve. Surgery involves some form of internal fixation of the spine to stop the curve getting worse over time. There are many techniques that may be used and your surgeon will discuss these with you.