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.