What Causes Scoliosis?

Scoliosis, a condition characterized by an abnormal lateral curvature of the spine, presents a complex puzzle in the medical world. Despite extensive research and clinical observation, the exact cause of scoliosis remains elusive in a significant majority of cases. Yet, understanding the known causes and identifying who is most at risk can significantly impact the management and treatment of this condition.

Idiopathic Scoliosis: The Enigmatic Majority

Remarkably, about 80% of scoliosis cases are classified as idiopathic, meaning their cause is unknown. This category primarily affects adolescents but can also be seen in infants and adults. The mystery of idiopathic scoliosis has puzzled healthcare professionals for years, leading to numerous theories but no definitive answers. However, this has not deterred the medical community from advancing treatment and management strategies for those affected.

Beyond the Unknown: Other Causes of Scoliosis

While idiopathic scoliosis accounts for the vast majority of cases, other forms of scoliosis have identifiable causes, each presenting unique challenges and requiring specialized approaches to treatment:

• Congenital Scoliosis: This form arises from spinal anomalies present at birth, resulting from the improper formation of the spine during fetal development. These structural abnormalities can lead to a significant curvature as the child grows.
• Neurological Scoliosis: Conditions affecting the nervous system, such as cerebral palsy or muscular dystrophy, can lead to scoliosis by impacting muscle control around the spine, resulting in a skewed posture and curvature.
• Scoliosis Secondary to Other Conditions: Certain systemic diseases, including Marfan’s and Ehlers-Danlos syndromes, which affect the connective tissues, can predispose individuals to developing scoliosis. These conditions often contribute to the complexity of managing scoliosis due to their systemic nature.
• Trauma: Although less common, scoliosis can result from traumatic injury to the spine. The damage can disrupt the normal growth or alignment of the spine, leading to curvature.

The Importance of Early Screening

Early detection of scoliosis can play a crucial role in managing the condition effectively. Screening programs in schools and pediatric health services aim to identify scoliosis at an early stage when interventions can be most beneficial. Girls are recommended to be screened for scoliosis at ages 10 and 12, while boys should be screened between 13 and 14 years old. This difference in screening age accounts for the typical onset of puberty and the associated growth spurts, which can rapidly exacerbate spinal curvature. Because many school scoliosis screening programs have been discontinued it’s advised that parents have their children screened by a provider that specializes in the non-surgical treatment of scoliosis.

Referral to Specialists: Knowing When

Adolescents presenting with curves over 10°and classified as Risser 0-1—indicating significant growth potential—are at a critical juncture. Their condition warrants referral to a specialist in the non-surgical treatment of scoliosis, where early intervention can potentially slow progression and improve outcomes. Curves of 20° with less growth remaining are still at risk of progressing and should also be referred to a scoliosis specialist.

Conversely, individuals with curves reaching 60° in the thoracic spine or 50° in the lumbar spine face increased risks and complications. At this juncture, a surgical consultation becomes necessary to evaluate the best course of action to prevent further progression and address the existing curvature.

Conclusion

Scoliosis remains a complex condition with a spectrum of causes ranging from the largely idiopathic to those stemming from congenital anomalies, neurological conditions, other systemic diseases, or trauma. The key to managing scoliosis lies in early detection, appropriate referral, and a tailored approach to treatment. As we continue to unravel the mysteries of scoliosis, the focus remains on improving the quality of life for those affected through comprehensive care and support. Understanding the causes and pathways of scoliosis not only aids in developing effective treatment strategies but also underscores the importance of a proactive and informed approach to spinal health.

About the author:

Dr. Chris Gubbels is a specialist in the non-surgical treatment of scoliosis and kyphosis. He’s advanced certified in Chiropractic BioPhysics, certified Scolibrace provider, Scolibalance level II certified, and an active member of SOSORT. He is the founder of Scolicare scoliosis treatment center in Denver, CO.