Scoliosis – Types, prognosis and management

Scoliosis is the Abnormal lateral curvature of the spine. It is classified into eight groups:
1. Structural scoliosis.
2. Non – structural scoliosis.
3. Postural scoliosis.
4. Paralytic scoliosis.
5. Neuropathic scoliosis.
6. Myopathic scoliosis.
7. Metabolic scoliosis.
8. Idiopathic scoliosis.
Structural scoliosis:
In structural scoliosis, there is a definite deformity of vertebrae. There is alteration in vertebral shape and mobility, and the deformity cannot be corrected by the alteration of posture. A careful history and examination is required to find a cause and give a prognosis, the two factors on which treatment depends. Structural scoliosis may be congenital, the deformity being due, for example, to a hemi-vertebra, fused vertebra, or absent or fused ribs.
Non – structural scoliosis:
In non – structural scoliosis the vertebrae are normal. The deformity is usually due to one of the following conditions: it may be compensatory, resulting from tilting of the pelvis from real or apparent shortening of one leg. It may be sciatic, and due to unilateral protective muscle spasm, especially that accompanying a prolapsed intervertebral disc.
Postural scoliosis:
This occurs most commonly in adolescent girls and generally resolves spontaneously.
Paralytic scoliosis:
The deformity is secondary to loss of the supportive action of the trunk and spinal muscles, nearly always as a sequel to anterior poliomyelitis.
Neuropathic scoliosis:
This condition is seen as a complication of neurofibromatosis, cerebral palsy, spina bifida, syringomyelia and other neuropathic conditions.
Myopathic scoliosis:
Primary disorders of the spinal musculature of the spine are responsible for myopathic scoliosis.
Metabolic scoliosis:
This is an uncommon condition, but occurs in cystine storage disease, Marfan’s syndrome and rickets.
Idiopathic scoliosis:
It is the commonest condition whose cause remains obscure. Usually several vertebrae are affected at one or two levels. In the area of primary curve there is loss of mobility and rotational deformity of the vertebrae. The spinal deformity is accompanied by the deformity of the shortening of the trunk.
Once the scoliosis is occurred in growing child the natural tendency is deterioration, which end at skeletal maturation. Sometimes the deterioration continues as a result of disc degeneration and vertebral subluxation.
Treatment may be advised if there is rapid deterioration or for cosmetic purposes. Other treatment modalities are available but none proved to be essentially good.