Here are some frequently asked questions about scoliosis:
What is scoliosis?
Scoliosis is a sideways curving of the spine. In addition to the sideways curvature, scoliosis involves rotation of the spine.
Adolescent Idiopathic Scoliosis (AIS) is the most common type of scoliosis and occurs most often during the growth spurt before puberty. It occurs in kids and teenagers between the ages of 10 and 18. The exact cause of the curving is unknown.
Other types of scoliosis include congenital scoliosis (scoliosis that is present at birth), early onset scoliosis (scoliosis that appears after birth and before the age of 10), neuromuscular scoliosis (scoliosis caused by a neurological or muscular condition), syndromic scoliosis (scoliosis that develops as part of a syndrome), and degenerative scoliosis (scoliosis in adults caused by the wear and tear of aging).
How do you find out if you have scoliosis?
Scoliosis is often found during routine checkups. When you go in for a checkup or have a physical exam, the doctor will ask you to bend forward to observe your spine. This test is called the Adam's Forward Bend Test. If you have scoliosis, your back may look uneven.
If your back is uneven, like in the picture above, your doctor will probably send you to get an x-ray of your spine. The x-ray will confirm if you have scoliosis, and it can reveal the severity of your scoliosis and the location of your curve.
How can you treat your scoliosis?
How your doctor decides to treat your scoliosis depends on many factors, including the severity of your curve. There are both conservative and non-conservative treatments for scoliosis.
Conservative treatment is treatment that does not involve surgery. This may involve bracing, stretching, physical therapy, etc.
Non-conservative treatment is treatment that does involve surgery.
Brace or orthosis?
An orthosis (plural: orthoses) is the more technical term for a "brace." An orthosis is a device that goes on the outside of the body and works to modify the bones and muscles. If you call your brace an orthosis, you will definitely earn some bonus points from your orthotist!
An orthotist is a person who is trained to design, create, and fit orthoses. This is the person you went to see for your scoliosis orthosis.
Orthotics is the career field devoted to designing, creating, and fitting orthoses.
What is your Cobb angle?
Your Cobb angle is a measure of the curvature of your spine in degrees. This measurement helps your doctor determine what type of treatment is necessary. In order to be diagnosed with scoliosis, your Cobb angle must be at least 10 degrees.
The Cobb angle also helps your doctor and orthotist track your scoliosis to see if your curve is progressing. The Cobb angle is measured using your x-ray, which is why it is very important to bring your most up-to-date x-rays to your appointments with your orthotist.
The apex of your curve is the the vertebra that is the farthest away from the middle of your body.
What do "thoracic" and "lumbar" mean?
The terms "thoracic" and "lumbar" refer to different regions of your spine. You have a total of 33 vertebrae, or backbones. You have 7 cervical vertebrae, 12 thoracic vertebrae, 5 lumbar vertebrae, 5 fused sacral vertebrae, and 4 fused coccygeal vertebrae. Scoliosis most commonly occurs in the thoracic and lumbar vertebrae. The most common curve pattern is a right thoracic curve and a left lumbar curve.
If the apex of your curve is a thoracic vertebra, your curve will be classified as a "thoracic curve."
If the apex of your curve is a lumbar vertebra, your curve will be classified as a "lumbar curve."
If the apex of your curve is the last thoracic vertebra or the first lumbar vertebra, your curve will be classified as a "thoracolumbar curve."
What is your Risser sign?
You may hear your doctor talk about your Risser sign when he or she is looking at your x-ray. The Risser sign helps doctors figure out the risk of your scoliosis getting worse, or progressing. The Risser sign measures how much mature bone has developed on the top part of your hip bones.
Risser Classification
You can be classified as Risser 0 - 5. Risser 0 means that the bone hasn't started to grow on top of your hip bones yet, so you still have a lot of growing to do. On the other hand, Risser 5 means that the all of new bone has developed and has fused to your hip bone, so you are close to done growing. Doctors use the Risser sign because for the most part, if you are growing, your curve is growing. If you still have a lot of growing to do, we want to make sure that we do everything we can to keep that curve from growing, too.
Bracing is an effective way to keep your curve under control as your grow. However, because bracing affects the growing spine, it will not help very much or help at all if you are done growing and skeletally mature. If you are almost done growing and are a Risser 4 or 5, your curve is probably close to done growing, too, so bracing may not be the best option.
Risser 3 on X-ray