A scoliosis means a permanent deformation of the spine in three dimensions. This deviation due to a torsion of the vertebrae, usually occurs during childhood, it can be the result of a malformation , a disease or idiopathy when the cause remains unknown. Scoliosis causes deformity of the chest and areas close to the spine. The ease of treatment depends on the severity of the deviation, which is why it is important to treat scoliosis at an early stage.
Definition of scoliosis
We must distinguish scoliosis of scoliosis . Scoliosis is a permanent deviation of the spine (spine) in the three planes of space (the three dimensions). The scoliotic attitude, on the other hand, results from a bad posture, without torsion of the vertebrae and without deformation, and can be easily corrected.
Causes of scoliosis
The idiopathic scoliosis is scoliosis whose origin is unknown, it appears mostly during childhood or during adolescence. Some put forward a hereditary factor , because it is not uncommon to see several members of the same family affected. These scoliosis are the most common, accounting for 70 to 80% of scoliosis.
A scoliosis can also be caused by a congenital malformation (which occurs at birth), or a neuromuscular or bone disease (myopathy, poliomyelitis …), a Marfan disease, etc. This is called secondary scoliosis .
It should be noted that bad postures, the practice of sports, the wearing of a binder too heavy or unbalanced diet are not involved in the occurrence of scoliosis.
Symptoms of scoliosis
A scoliosis is not always diagnosed at an early stage because usually it does not cause any particular pain. Back pain and observation of the spine can alert parents.
The visible sign is a malformation of the spine, an appearance of poor posture and especially a lump on one side of the back when the child leans forward. This hump is called a hump.
Populations at risk
Although it may occur in adulthood, scoliosis mainly affects children and adolescents. Girls are more exposed than boys and the deviation of the spine is generally greater than in the latter: 80% of scoliosis appears in girls. 2 to 3% of adolescents have scoliosis, but it is really important in less than 1% of them.
Adolescence is a risk period because scoliosis evolves slowly before adolescence, but can then evolve and worsen very quickly, because of rapid growth.
Diagnosis of scoliosis
One shoulder slightly higher than the other may be enough to get the doctor’s attention. In order to appreciate the deviation of the spine, he asks the patient to stand up, bare-chested, with his feet together, to observe asymmetry . Then he makes him bend forward, legs outstretched, to highlight the hump, visible bump on one side of the column.
With radiographs, we explore scoliosis to know the exact location where it is located and especially its angle. Because this angle will condition the treatment.
Treatment of scoliosis
Treatment of scoliosis is a long-term treatment that takes place over several years. If the deviation of the column is not very pronounced, scoliosis requires no special treatment and should simply be followed especially in early adolescence where it can worsen very quickly.
All sports are beneficial, especially swimming which results in an extension of the spine. Physiotherapy is used to maintain a good muscular condition, but it is not enough to prevent the aggravation of scoliosis. The techniques of muscle stimulation by electrotherapy do not seem to give interesting results.
Scoliosis should be treated in about 1 in 2 children as soon as the angle of deformity reaches 15 to 20 °. The wearing a corset helps to avoid the aggravation and straighten the curvature. These corsets must be worn 24 hours a day, and are removed only for the toilet. They must be worn while the bones of the vertebrae are mature and their shape fixed. Thus, they are no longer likely to deform.
In some cases, treatment of scoliosis is surgical , especially when the curvature worsens despite the wearing of the brace or the angle of deformation reaches 35 ° or more depending on the area of scoliosis. The operation can be performed in cases of severe scoliosis of a very young child, or after the age of 10 years.
When treatment has not been completed before the end of growth, surgeons can operate adults, but operations are often heavier. Several types of surgical procedures are possible. We can sometimes treat the cause (a vertebra malformation, a deformation, an occipital hole too narrow …). The surgeon can also secure vertebrae to each other to block them, and this by bone graft, then sets up metal rods with screws, to straighten the column. This makes it possible to obtain a straight spine, but stiff in one place, which is less disabling than a twisted column.
Prevention of scoliosis
Although it is true that a large number of scoliosis remains of unknown origin, it is possible to prevent their evolution thanks to an early detection . Having your child examined regularly by a doctor, especially during growth, allows for early management.
It is especially important to follow very closely the scoliosis detected and of low importance, especially from the beginning of adolescence, in order to treat them as quickly as possible in case of need and avoid complications.
Complementary approaches to scoliosis
There is no evidence of the effectiveness of osteopathy in the treatment of scoliosis. This does not mean that you should avoid osteopathy that can help accompany medical treatment.
It can be interesting to fight scoliotic attitudes, but cannot be a treatment for scoliosis.
It is necessary to adopt some good habits to promote the treatment of scoliosis. These include the regular practice of a sport. The ideal is to swim.
– Professor Philippe MERLOZ – The scoliosis.September 2004