Scoliosis
One of the most dreaded words for parents of young girls is the word scoliosis, a three-dimensional deformation of the spine, with the appearance of lateral curves. Other similar deformities are kyphosis and lordosis, but for some strange reason they never acquired the emotional charge of scoliosis.
Depending on the age of onset, scoliosis may affect infants, children, adolescents and adults. Scoliosis may be divided into idiopathic, i.e. of unknown etiology, and secondary, when an underlying pathology is recognized as the underlying cause of the deformity.
It is additionally distinguished into functional or antalgic, usually transitory, present only while symptoms last, and organic or permanent. Of all the above categories, the one that most commonly concerns doctors and patients alike is idiopathic adolescent scoliosis, which appears suddenly during the age of rapid skeletal growth and may rapidly worsen if not diagnosed and treated in time. This type of scoliosis may cause particular stress on the whole family, not just the young patient.
In fact, scoliosis is so intertwined with the medical specialty of orthopedics that it is depicted on the logo of most Orthopedic Societies around the world. The central idea of this logo is a small growing tree with apparent deformity in the lateral plane. The intervention of the specialist (physician or gardener alike) consists in the application of the Orthopede, i.e. a restraining system (as simple as a straight pole) to avoid further deformation and provide a scaffold for the developing organism (plant or animal alike).
Scoliosis is easily diagnosed by the medical specialist with a simple clinical examination and the search for equally simple diagnostic signs. Such signs are tilting of the body to one side, elevation of the ribs during the bending test, uneven shoulder blades, asymmetry of the two halves in relation to the midline. When indicated, the diagnosis is confirmed by taking x-rays of the whole spine.
However, early diagnosis is of outmost importance. For this very reason, screening programs have been established, usually by early puberty, during school hours and at the school facility. However, their real-life effectiveness may be problematic. Nevertheless, the diagnosis, in the earliest possible stages, may have a significant effect on the final outcome.
The treatment is divided into conservative and operative, usually reserved for the most severe cases, when exceeding 40 degrees of curvature and especially when curves are gradually worsening. The proposed variations both for conservative treatment with different braces and operative treatment with various implants and techniques are numerous, but also ever evolving.