Scoliosis, a condition characterized by a sideways curvature of the spine, is a concern for many, particularly as it’s often diagnosed during adolescence. While scoliosis is recognizable by the visible curve it creates, the question of “What Causes Scoliosis” remains a complex one, especially for the most common type. This article delves into the various factors that contribute to scoliosis, helping to clarify the causes and risk factors associated with this spinal condition.
Understanding Scoliosis and Spinal Curvature
Typically, when viewed from the side, a healthy spine presents a gentle S-shape, with a slight outward curve in the upper back and a subtle inward curve in the lower back. However, when viewed from behind, the spine should ideally appear as a straight line from the neck to the tailbone. Scoliosis disrupts this straight alignment, causing the spine to curve sideways, often forming a C or S shape.
While scoliosis can sometimes be linked to conditions like cerebral palsy and muscular dystrophy, the majority of scoliosis cases, especially in children, are idiopathic, meaning the exact cause is not definitively known.
The Enigma of Idiopathic Scoliosis: The Most Common Form
Idiopathic scoliosis is the most prevalent type, particularly affecting adolescents. Despite extensive research, the precise cause of idiopathic scoliosis remains elusive. However, it is widely believed to have a hereditary component, as the condition is observed to run in families. This suggests that genetic factors may play a significant role in predisposing individuals to develop this type of scoliosis. Research continues to explore specific genes and genetic markers that might be involved in the development of idiopathic scoliosis.
Less Common Causes of Scoliosis: Identifying Underlying Conditions
While idiopathic scoliosis constitutes the majority of cases, other less common types of scoliosis have identifiable causes. These include:
- Neuromuscular Conditions: Certain conditions that affect the muscles and nervous system, such as cerebral palsy and muscular dystrophy, can lead to neuromuscular scoliosis. These conditions can weaken the muscles that support the spine, resulting in spinal curvature.
- Congenital Scoliosis: This type of scoliosis is present at birth and is caused by birth defects affecting the development of the vertebrae. Abnormalities in the formation or segmentation of the spinal bones during fetal development can result in congenital scoliosis.
- Chest Wall Surgery: Infants who have undergone surgery on the chest wall can sometimes develop scoliosis as a consequence. This is often related to the impact of surgery on the developing rib cage and spine.
- Spinal Injuries or Infections: Trauma to the spine or infections affecting the spinal column can, in some instances, lead to the development of scoliosis. These events can disrupt the normal structure and support of the spine.
- Spinal Cord Irregularities: Abnormalities within the spinal cord itself, such as tethered spinal cord or syringomyelia, can also contribute to scoliosis. These conditions can affect the nerves and muscles that support spinal alignment.
Risk Factors for Developing Scoliosis
Several factors can increase the likelihood of developing scoliosis, particularly idiopathic scoliosis:
- Age: The onset of idiopathic scoliosis typically occurs during adolescence. The rapid growth spurt during these years may be a contributing factor in the development and progression of spinal curves.
- Sex: While both boys and girls can develop mild scoliosis at roughly the same rate, girls face a significantly higher risk of the curve worsening and requiring medical intervention. The reasons for this gender disparity are still being researched.
- Family History: As mentioned, scoliosis can have a familial tendency. Having a family history of scoliosis increases the risk, although most children with scoliosis do not have a direct family history of the condition.
Potential Complications Associated with Scoliosis
Although many individuals with scoliosis have mild curves that do not cause significant problems, scoliosis can sometimes lead to complications, especially if the curvature is severe and left untreated:
- Breathing Problems: In severe cases of scoliosis, the spinal curve can become pronounced enough to reduce the space within the chest cavity. This can compress the lungs, making it difficult to breathe effectively.
- Chronic Back Pain: Adults who had scoliosis as children, particularly those with larger, untreated curves, are more prone to experiencing chronic back pain. The abnormal spinal alignment can put stress on muscles and ligaments, leading to pain over time.
- Appearance Concerns: As scoliosis progresses, it can cause noticeable changes in physical appearance. These may include uneven shoulders and hips, a prominent rib cage, and a visible shift of the waist and trunk to one side. These changes can lead to self-consciousness and body image issues.
Seeking Answers and Guidance
Understanding “what causes scoliosis” is an ongoing area of medical research. While the exact cause of idiopathic scoliosis remains unclear, significant progress has been made in identifying contributing factors and risk factors. If you notice any signs of scoliosis in yourself or your child, it is essential to consult a healthcare provider. Early detection and monitoring are crucial for managing scoliosis and mitigating potential complications.
References
- Scoliosis in children and teens: In depth. National Institute of Arthritis and Musculoskeletal and Skin Diseases. https://www.niams.nih.gov/health-topics/scoliosis/advanced. Accessed April 7, 2021.
- Introduction to scoliosis. American Academy of Orthopaedic Surgeons. https://orthoinfo.aaos.org/en/diseases–conditions/introduction-to-scoliosis. Accessed April 7, 2021.
- Kliegman RM, et al. The spine. In: Nelson Textbook of Pediatrics. 21st ed. Elsevier; 2020. https://www.clinicalkey.com. Accessed April 7, 2021.
- Scherl SA. Adolescent idiopathic scoliosis: Clinical features, evaluation and diagnosis. https://www.uptodate.com/contents/search. Accessed April 7, 2021.
- Ferri FF. Scoliosis. In: Ferri’s Clinical Advisor 2021. Elsevier; 2021. https://www.clinicalkey.com. Accessed April 7, 2021.
- Scherl SA. Adolescent idiopathic scoliosis: Management and prognosis. https://www.uptodate.com/contents/search. Accessed April 7, 2021.
- Miller MD, et al., eds. The adolescent: Scoliosis. In: Essential Orthopaedics. 2nd ed. Elsevier; 2020. https://www.clinicalkey.com. Accessed April 7, 2021.
- Kim W, et al. Clinical evaluation, imaging and management of adolescent idiopathic and adult degenerative scoliosis. In: Current Problems in Diagnostic Radiology. 2019; doi.org/10.1067/j.cpradiol.2018.08.006.
- Azar FM, et al. Scoliosis and kyphosis. In: Campbell’s Operative Orthopaedics. 14th ed. Elsevier; 2021. https://www.clinicalkey.com. Accessed April 7, 2021.
- Surgical treatment for scoliosis. American Academy of Orthopaedic Surgeons. https://orthoinfo.aaos.org/en/treatment/surgical-treatment-for-scoliosis. Accessed April 7, 2021.
- Devlin VJ. Idiopathic scoliosis. In: Spine Secrets. 3rd ed. Elsevier; 2021. https://www.clinicalkey.com. Accessed April 7, 2021.
- Larson AN (expert opinion). Mayo Clinic. April 30, 2021.
- Fedorak GT, et al. Minimum 5-year follow-up of Mehta casting to treat idiopathic early-onset scoliosis. The Journal of Bone and Joint Surgery. 2019; doi:10.2106/JBJS.18.01268.
- Shands AR. End result of the treatment of idiopathic scoliosis. The Journal of Bone and Joint Surgery. 1941;23:963.
- Morrow ES Jr. Allscripts EPSi. Mayo Clinic. Feb. 16, 2021.
