January 8, 2024 Author : Maia Gonçalves Idiopathic scoliosis is a rotational deviation of the spine that occurs during pre-adolescence and adolescence. The name idiopathic means that there is no diagnosed cause for it . In young people, idiopathic scoliosis: May be present in 2%-4% of children aged 10-16; Affects boys and girls equally; The probability of progressing favorably without treatment is 10 times greater in girls. Scoliosis signs and symptoms Minor scoliosis may not cause any symptoms and may only be detected during a routine medical consultation. However, some signs may raise suspicion of scoliosis : One shoulder is higher than the other; A more pronounced skin fold on one side of the waist; Asymmetry on the right and left sides of the anterior and/or posterior chest wall, namely one shoulder blade more prominent than the other; Perception that the legs have a different length; Difficulty with some clothes fitting well, for example shirts, sweaters or coats. Most scoliosis curvatures are convex to the right in the thoracic region and to the left in the lumbar region, thus leaving the right shoulder higher than the left. Scoliosis is a rotation of the spine whereby the back protrudes to the right or left. Symptoms and complaints reported by people with scoliosis may include: Back pain, especially in areas of tension; Pain/discomfort in the lower back after being in the same position for a long time, for example sitting or standing. More severe scoliosis can cause respiratory complaints, but the diagnosis is almost always made before this happens. Diagnosis The diagnosis of scoliosis is based on: Symptoms and signs present; Physical examination performed, particularly dedicated to the evaluation of the spine and its deviation. For example, in scoliosis, the deviation is more pronounced when patients flex their trunk forward (Adams test); Imaging tests, usually an extra-long X-ray (radiography), with anteroposterior and lateral views. The degree of scoliosis is calculated based on imaging tests, measuring an angle formed by the intersection of lines that are drawn taking into account specific positions of the vertebrae involved in the curvature. This angle is called Cobb angle and when it is greater than 10 degrees there is scoliosis. Scoliosis treatment When scoliosis is mild and growth is finished, no treatment may be necessary . Even when the growth has not yet ended, the option may be to simply maintain follow up to check that there is no worsening and intervene only if this happens. In other cases, treatment depends on several factors such as : Age and complaints; Likelihood of worsening and other particular circumstances of each patient; Severity of scoliosis given by measuring the Cobb angle and, as a general rule, it is considered: Lower 25 degrees: postural treatment for muscle strengthening; 25-45 degrees: use of thoracolumbar orthosis; Greater 45 degrees: corrective surgery. When scoliosis is not major, there may be no long-term problems other than back pain. When scoliosis is severe and is left untreated, it can lead to respiratory and heart problems, as well as affecting physical and psychological well-being . Meet the orthopedics clinical team from Hospital da Luz network. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
