Monday, February 18, 2013

Scoliosis Frequently Asked Questions

Why does scoliosis develop most often in late childhood?
Why is it more common in girls? Scoliosis most often develops in late childhood because of the association between growth and progressive scoliosis curves. Although scoliosis can develop at any age, including infantile (age birth- 3), Juvenile (age 3-10), adolescent (age 10-18) and adult (> age 18), the most common time to detect curves are in late childhood/early teen years. Thus, the most common form seen, Adolescent Idiopathic Scoliosis (AIS), is detected between ages 10 and 18, often just before or after puberty and the associated adolescent growth spurt. Small curves (10-20 degrees) are nearly equally found in boys and girls, but larger curves which often need treatment (those > 40 degrees) are seen in females to males in a 9:1 ratio. It is a bit unclear why that is the case, it may certainly be a genetic tendency, and/or something relating to hormonal alterations or connective tissue adaptations for the potential for childbirth in females.

What causes some children to develop scoliosis while others do not?
Is it simply genetic or are there other factors involved? Although there are many potential etiologic factors implicated for idiopathic scoliosis development, the genetic aspects are probably the most influential. Multiple genetic studies have confirmed strong family relations including studies of identical vs paternal twins. Other factors such as various hormones, equilibrium and balance issues have been promoted as well, but none are conclusive. The genetic factors are strong but highly complex, multigene interactions that are still being actively investigated, including here at Washington University by Dr Matt Dobbs of the Department of Orthopedic Surgery.

What causes adults to develop scoliosis?
Adults can develop scoliosis as a result of slow progression of childhood curves that were untreated, or as curves that develop on their own from aging of the spine, usually in the lower (lumbar) region and termed "de novo" adult lumbar scoliosis. These de novo curves result from progressive degeneration of the joints in the back of the spine along with degeneration of the discs supporting the front of the spine. Although this natural aging process occurs in everyone, only certain people will develop a corresponding scoliosis with the process.

To read more Scoliosis FAQ's, please visit our website at: http://www.ortho.wustl.edu/content/Patient-Care/3319/SERVICES/Spine/Scoliosis-FAQ.aspx.

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