Scoliosis: the Definition

Scoliosis, effecting as many as 6million people in the United States according to the National Scoliosis Foundation, is not just a lateral curvature of spine as many believes. In reality, it's a 3-D deformity of the spine which has not only lateral component, but also the rotational component and saggital curve changes as well. The reason that many texts cite it as lateral curvature is because when you take a helical structures like DNA for example and take a 2-D picture, what you get is a picture of a structure curving side to side. So what you can observe from 2-D x-ray study of scoliosis is spine curving from side to side. But even in 2-D studies like x-ray, rotational component is obvious as you can tell by position of the spinous processes or the sizes of pedicles. And taking lateral view lets one appreciate the increase or decrease of kyphotic or lordotic curvatures as well.

There are many types of scoliosis. This article will concentrate mainly on a condition called idiopathic scoliosis. The word idiopathic means of unkown cause. Up until recently, there's been numerous theories regarding scoliosis' origin. But we now know more about the condition. So perhaps, the word idiopathic no longer is appropriate.

Recently it was found that defect in the gene -- known as CHD7 -- leads to scoliosis, according to researchers at the Washington University School of Medicine in St. Louis; University of Texas Southwestern Medical Center and Texas Scottish Rite Hospital for Children, both in Dallas; Rutgers State University of New Jersey and the University of Iowa.

For many years, scientists have known that there's family linkage. But pinpointing an exact cause was not easy due to multifactorial contribution. There's more than one gene that effects spinal development and recent finding only uncovered one of them. There may be an environmental trigger as well which hasn't been identified: that is if it exists.

So what causes idiopathic scoliosis? Each spinal vertebra has multiple growth centers and during developmental age, one of the of the growth centers can lag behind others' growth rate causing slight wedging deformity of vertebra. This can cause increased loading to the lagging side and eventually add to growth inhibition while other growth centers are growing at a normal rate. This is why growth spurt is such a dangerous stage for idiopathic scoliosis patients.

Many states in US do perform scoliosis screening. However, due to lack of interest from legislators some states, like California for example, only perform it once in a child's life time, at age12 for girls and 13 for boys. So those conditioins that develope early on can become surgical cases even before it is detected.

Today, with new nonsurgical treatments availabe, scoliosis is very treatable in early stages. Proper scoliosis screening, whether done at home or at school, is extremely important as many may avoid major surgeries if intervention could be made properly.

Part 2: Treatment Options
Part 3: What Can Be Done?