Entries

Gale Encyclopedia of Children's Health: Infancy through Adolescence Gale Encyclopedia of Medicine, 3rd ed.Gale Encyclopedia of Alternative MedicineUXL Complete Health Resource Further reading

NON JS

Scoliosis

Scoliosis

Definition

Scoliosis is a side-to-side curvature of the spine.

Description

When viewed from the rear, the spine usually appears perfectly straight. Scoliosis is a lateral (side-to-side) curve in the spine, usually combined with a rotation of the vertebrae. (The lateral curvature of scoliosis should not be confused with the normal set of front-to-back spinal curves visible from the side.) While a small degree of lateral curvature does not cause any medical problems, larger curves can cause postural imbalance and lead to muscle fatigue and pain . More severe scoliosis can interfere with breathing and lead to arthritis of the spine (spondylosis).

Demographics

Approximately 10 percent of all adolescents have some degree of scoliosis, although fewer than 1 percent have curves that require medical attention beyond monitoring. Scoliosis is found in both boys and girls, but a girl's spinal curve is much more likely to progress than a boy's. Girls require scoliosis treatment about five times more often than boys. The reason for these differences as of 2004 was not known.

Causes and symptoms

Four out of five cases of scoliosis are idiopathic, meaning the cause is unknown. While idiopathic scoliosis tends to run in families, no specific genes responsible for the condition have been identified. Children with idiopathic scoliosis appear to be otherwise entirely healthy and have not had any bone or joint disease early in life. Scoliosis is not caused by poor posture, diet, or carrying a heavy book bag on one shoulder.

Idiopathic scoliosis is further classified according to age of onset:

  • Infantile: Curvature appears before age three. This type is quite rare in the United States but is more common in Europe.
  • Juvenile: Curvature appears between ages three and ten. This type may be equivalent to the adolescent type, except for the age of onset.
  • Adolescent: Curvature usually appears between ages of ten and 13, near the beginning of puberty . This is the most common type of idiopathic scoliosis.
  • Adult: Curvature begins after physical maturation is completed.

Causes are known for three other types of scoliosis:

  • Congenital scoliosis is due to abnormal formation of the bones of the spine and is often associated with other organ defects.
  • Neuromuscular scoliosis is due to loss of control of the nerves or muscles that support the spine. The most common causes of this type of scoliosis are cerebral palsy and muscular dystrophy .
  • Degenerative scoliosis may be caused by breaking down of the discs that separate the vertebrae or by arthritis in the joints that link them.

Scoliosis causes a noticeable asymmetry in the torso when viewed from the front or back. The first sign of scoliosis is often seen when a child is wearing a bathing suit or underwear. A child may appear to be standing with one shoulder higher than the other or to have a tilt in the waistline. One shoulder blade may appear more prominent than the other due to rotation. In girls, one breast may appear higher than the other or larger if rotation pushes one side forward.

Curve progression is greatest near the adolescent growth spurt. Scoliosis that begins early is more likely to progress significantly than scoliosis that begins later in puberty.

When to call the doctor

If the parent notices that a child's posture is abnormal, if when the child stands one hip appears to be higher than the other, if one shoulder blade appears to be sticking out, or the child appears to lean regularly to one side, the doctor should be notified. If the child is screened at school and the screener reports a suspicion of scoliosis, a doctor should be seen to follow up on this suspicion.

Diagnosis

Diagnosis for scoliosis is done by an orthopedist. A complete medical history is taken, including questions about family history of scoliosis. The physical examination includes determination of pubertal development in adolescents, a neurological exam (which may reveal a neuromuscular cause), and measurements of trunk asymmetry. Examination of the trunk is done while the patient is standing, bending over, and lying down and involves both visual inspection and use of a simple mechanical device called a scoliometer.

If a curve is detected, one or more x rays will usually be taken to define the curve or curves more precisely. An x ray is also used to document spinal maturity, any pelvic tilt or hip asymmetry, and the location, extent, and degree of curvature. The curve is defined in terms of where it begins and ends, in which direction it bends, and by an angle measure known as the Cobb angle. The Cobb angle is found by taking an x ray of the spine. Lines are then projected out parallel to the vertebrae at the top and bottom of the curve. Then perpendicular lines are projected from these lines and the angle at which the lines intersect is measured. These angles are referred to when the angle of the curvature is discussed. To properly track the progress of scoliosis, it is important to project from the same points of the spine each time a measurement is made; otherwise, there is a risk of getting misleading measurements.

Occasionally, magnetic resonance imaging (MRI) is used as a diagnostic tool, primarily to look more closely at the condition of the spinal cord and nerve roots extending from it if neurological problems are suspected.

Treatment

Treatment decisions for scoliosis are based on the degree of curvature, the likelihood of significant progression, and the presence of pain, if any.

Curves less than 20 degrees are not usually treated, except by regular follow-up for children who are still growing. Watchful waiting is usually all that is required in adolescents with curves of 20 to 30 degrees as long as there is no pain.

For children or adolescents whose curves progress to 30 degrees and who have a year or more of growth left, bracing may be required. Bracing cannot correct curvature but may be effective in halting or slowing progression.

Two styles of braces are used for daytime wear. The Milwaukee brace consists of metal uprights attached to pads at the hips, rib cage, and neck. The other kind of brace is the underarm brace, which uses rigid plastic to encircle the lower rib cage, abdomen, and hips. Both these brace types hold the spine in a vertical position. Because it can be worn out of sight beneath clothing, the underarm brace is better tolerated and often leads to better compliance. A third style, the Charleston bending brace, is used at night to bend the spine in the opposite direction. Braces are often prescribed to be worn for 22 to 23 hours per day, though some clinicians allow or encourage removal of the brace for exercise .

Bracing may be appropriate for scoliosis due to some types of neuromuscular disease, including spinal muscular atrophy , before growth is finished. Duchenne muscular dystrophy is not treated by bracing. Surgery is likely to be required.

Surgery is usually the option of last resort in cases of scoliosis. Surgery for idiopathic scoliosis is usually recommended if one of the following conditions is present:

  • The curve has progressed despite bracing.
  • The curve is greater than 40 to 50 degrees before growth has stopped in an adolescent.
  • There is significant pain.

Orthopedic surgery for neuromuscular scoliosis is often done earlier. The goals of surgery are to correct the deformity as much as possible, to prevent further deformity, and to eliminate pain as much as possible. Surgery can usually correct 40 to 50 percent of the curve, and sometimes as much as 80 percent. Surgery cannot always completely remove pain.

The surgical procedure for scoliosis is called spinal fusion, because the goal is to straighten the spine as much as possible and then to fuse the vertebrae together to prevent further curvature. To achieve fusion, the involved vertebra are first exposed and then scraped to promote regrowth. Bone chips are usually used to splint together the vertebrae to increase the likelihood of fusion. To maintain the proper spinal posture before fusion occurs, metal rods are inserted alongside the spine and are attached to the vertebrae by hooks, screws, or wires. Fusion of the spine makes it rigid and resistant to further curvature. The metal rods are no longer needed once fusion is complete but are rarely removed unless their presence leads to complications.

Spinal fusion leaves the involved portion of the spine permanently stiff and inflexible. While this leads to some loss of normal motion, most functional activities are not strongly affected, unless the very lowest portion of the spine (the lumbar region) is fused. Normal mobility, exercise, and even contact sports are usually all possible after spinal fusion. Full recovery takes approximately six months. Physical therapy is part of standard treatment as well.

Alternative treatment

Numerous alternative therapies have been touted to provide relief and help for individuals with scoliosis, but none has been proven beneficial in clinical trials. These include massage and electrical stimulation. In addition, alternatives such as rolfing or chiropractic manipulation of soft tissue to improve alignment may provide improved flexibility, stronger muscles, and pain relief but cannot prevent or correct the curvature of the spine or its progression.

Although important for general health and strength, exercise has not been shown to prevent or slow the development of scoliosis. It may help relieve pain from scoliosis by helping to maintain range of motion. Aquatic exercise, in particular, can increase flexibility and improve posture, balance, coordination, and range of motion. Because it decreases joint compression, it can lessen the pain caused by scoliosis or surgery.

Good nutrition is also important for general health, but no specific dietary regimen has been shown to control scoliosis development. In particular, dietary calcium levels do not influence scoliosis progression.

Chiropractic treatment may relieve pain, but it cannot halt scoliosis development and should not be a substitute for conventional treatment of progressing scoliosis. Acupuncture and acupressure may also help reduce pain and discomfort, but these treatments cannot halt scoliosis development either.

Prognosis

The prognosis for a child with scoliosis depends on many factors, including the age at which scoliosis begins and the treatment received. More importantly, mostly unknown individual factors affect the likelihood of progression and the severity of the curve. Most cases of mild adolescent idiopathic scoliosis need no treatment and do not progress. Untreated severe scoliosis often leads to spondylosis and may impair breathing. Degenerative arthritis of the spine, sciatica, and severe physical deformities can also result if severe scoliosis is left untreated. Finally, scoliosis can also poorly affect the individual's self-esteem and cause serious emotional problems.

Prevention

There is no known way to prevent the development of scoliosis. Progression of scoliosis may be prevented through bracing or surgery. More than 30 states have screening programs in schools for adolescent scoliosis, usually conducted by trained school nurses or physical education teachers. These programs can help to catch scoliosis early, so that treatment can begin and progression can often be halted or slowed.

Parental concerns

Children with scoliosis often have a negative self-image associated with irregular posture or having to wear a brace. This problem is being combated with new braces that can be worn under the clothing and are more discreet than traditional braces. Scoliosis can be life threatening if it is not treated and progresses to a point at which breathing is impaired. This is very rare, however. Scoliosis should be watched carefully by a physician for signs of worsening, but it usually does not progress to the point at which treatment is needed.

Resources

BOOKS

Hooper, Nancy J. Stopping Scoliosis: The Whole Family Guide to Diagnosis and Treatment. East Rutherford, NJ: Penguin Group, 2002.

Lenke, Lawrence, et al. Modern Anterior Scoliosis Surgery. St. Louis, MO: Quality Medical Publishing, 2002.

Newton, Peter O. Adolescent Idiopathic Scoliosis. Rosemont, IL: Academy of Orthopaedic Surgeons, 2004.

Schommer, Nancy. Stopping Scoliosis: The Complete Guide to Diagnosis and Treatment, 2nd ed. New York: Avery, 2002.

Silverstein, Alvin. Scoliosis. Minneapolis, MN: Sagebrush Education Resources, 2003.

Spray, Michelle L., et al. Growing Up with Scoliosis: A Young Girl's Story. Stratford, CT: Book Shelf Inc., 2002.

PERIODICALS

Sullivan, Michele G. "Surgical Stapling Can Halt Curve of Scoliosis: Orthotics Can Be Helpful." Family Practice News 33 (December 15, 2003): 35.

Wachter, Kerry. "Prognosis for Scoliosis Better than Once Thought." Family Practice News 33 (July 1, 2003): 59.

Weomstoem. Stuart, et al. "Health and Function of Patients with Untreated Idiopathic Scoliosis: a 50-Year Natural History Study." The Journal of the American Medical Association 289 (February 5, 2003): 559.

ORGANIZATIONS

National Scoliosis Foundation. 5 Cabot Place, Stoughton, MA 02072. Web site: <www.scoliosis.org>.

Scoliosis Research Society. 55 East Wells St. Suite 1100. Milwaukee, WI 532023823. Web site: <www.srs.org>.

Tish Davidson, A.M. Liz Meszaros

KEY TERMS

Cobb angle A measure of the curvature of scoliosis, determined by measurements made on x rays.

Rolfing A holistic system of bodywork that uses deep manipulation of the body's soft tissue to realign and rebalance the body's myofacial (connective) structure. It is used to improve posture, relieve chronic pain, and reduce stress.

Cite this article
Pick a style below, and copy the text for your bibliography.

  • MLA
  • Chicago
  • APA

Davidson, Tish; Meszaros, Liz. "Scoliosis." Gale Encyclopedia of Children's Health: Infancy through Adolescence. 2006. Encyclopedia.com. 27 Sep. 2016 <http://www.encyclopedia.com>.

Davidson, Tish; Meszaros, Liz. "Scoliosis." Gale Encyclopedia of Children's Health: Infancy through Adolescence. 2006. Encyclopedia.com. (September 27, 2016). http://www.encyclopedia.com/doc/1G2-3447200504.html

Davidson, Tish; Meszaros, Liz. "Scoliosis." Gale Encyclopedia of Children's Health: Infancy through Adolescence. 2006. Retrieved September 27, 2016 from Encyclopedia.com: http://www.encyclopedia.com/doc/1G2-3447200504.html

Scoliosis

Scoliosis

Definition

Scoliosis is a side-to-side curvature of the spine.

Description

When viewed from the rear, the spine usually appears perfectly straight. Scoliosis is a lateral (side-to-side) curve in the spine, usually combined with a rotation of the vertebrae. (The lateral curvature of scoliosis should not be confused with the normal set of front-to-back spinal curves visible from the side.) While a small degree of lateral curvature does not cause any medical problems, larger curves can cause postural imbalance and lead to muscle fatigue and pain. More severe scoliosis can interfere with breathing and lead to arthritis of the spine (spondylosis).

Approximately 10% of all adolescents have some degree of scoliosis, though fewer than 1% have curves which require medical attention beyond monitoring. Scoliosis is found in both boys and girls, but a girl's spinal curve is much more likely to progress than a boy's. Girls require scoliosis treatment about five times as often. The reason for these differences is not known.

Causes and symptoms

Four out of five cases of scoliosis are idiopathic, meaning the cause is unknown. While idiopathic scoliosis tends to run in families, no responsible genes had been identified as of 1997. Children with idiopathic scoliosis appear to be otherwise entirely healthy, and have not had any bone or joint disease early in life. Scoliosis is not caused by poor posture, diet, or carrying a heavy bookbag exclusively on one shoulder.

Idiopathic scoliosis is further classified according to age of onset:

  • Infantile. Curvature appears before age three. This type is quite rare in the United States, but is more common in Europe.
  • Juvenile. Curvature appears between ages 3 and 10. This type may be equivalent to the adolescent type, except for the age of onset.
  • Adolescent. Curvature appears between ages of 10 and 13, near the beginning of puberty. This is the most common type of idiopathic scoliosis.
  • Adult. Curvature begins after physical maturation is completed.

Causes are known for three other types of scoliosis:

  • Congenital scoliosis is due to congenital abnormal formation of the bones of the spine, and is often associated with other organ defects.
  • Neuromuscular scoliosis is due to loss of control of the nerves or muscles which support the spine. The most common causes of this type of scoliosis are cerebral palsy and muscular dystrophy.
  • Degenerative scoliosis may be caused by degeneration of the discs which separate the vertebrae or arthritis in the joints that link them.

Scoliosis causes a noticeable asymmetry in the torso when viewed from the front or back. The first sign of scoliosis is often seen when a child is wearing a bathing suit or underwear. A child may appear to be standing with one shoulder higher than the other, or to have a tilt in the waistline. One shoulder blade may appear more prominent than the other due to rotation. In girls, one breast may appear higher than the other, or larger if rotation pushes that side forward.

Curve progression is greatest near the adolescent growth spurt. Scoliosis that begins early on is more likely to progress significantly than scoliosis that begins later in puberty.

More than 30 states have screening programs in schools for adolescent scoliosis, usually conducted by trained school nurses or gym teachers.

Diagnosis

Diagnosis for scoliosis is done by an orthopedist. A complete medical history is taken, including questions about family history of scoliosis. The physical examination includes determination of pubertal development in adolescents, a neurological exam (which may reveal a neuromuscular cause), and measurements of trunk asymmetry. Examination of the trunk is done while the patient is standing, bending over, and lying down, and involves both visual inspection and use of a simple mechanical device called a scoliometer.

If a curve is detected, one or more x rays will usually be taken to define the curve or curves more precisely. An x ray is used to document spinal maturity, any pelvic tilt or hip asymmetry, and the location, extent, and degree of curvature. The curve is defined in terms of where it begins and ends, in which direction it bends, and by an angle measure known as the Cobb angle. The Cobb angle is found by projecting lines parallel to the vertebrae tops at the extremes of the curve; projecting perpendiculars from these lines; and measuring the angle of intersection. To properly track the progress of scoliosis, it is important to project from the same points of the spine each time.

Occasionally, magnetic resonance imaging (MRI) is used, primarily to look more closely at the condition of the spinal cord and nerve roots extending from it if neurological problems are suspected.

Treatment

Treatment decisions for scoliosis are based on the degree of curvature, the likelihood of significant progression, and the presence of pain, if any.

Curves less than 20 degrees are not usually treated, except by regular follow-up for children who are still growing. Watchful waiting is usually all that is required in adolescents with curves of 20-30 degrees, or adults with curves up to 40 degrees or slightly more, as long as there is no pain.

For children or adolescents whose curves progress to 30 degrees, and who have a year or more of growth left, bracing may be required. Bracing cannot correct curvature, but may be effective in halting or slowing progression. Bracing is rarely used in adults, except where pain is significant and surgery is not an option, as in some elderly patients.

Two general styles of braces are used for daytime wear. The Milwaukee brace consists of metal uprights attached to pads at the hips, rib cage, and neck. The underarm brace uses rigid plastic to encircle the lower rib cage, abdomen, and hips. Both these brace types hold the spine in a vertical position. Because it can be worn out of sight beneath clothing, the underarm brace is better tolerated and often leads to better compliance. A third style, the Charleston bending brace, is used at night to bend the spine in the opposite direction. Braces are often prescribed to be worn for 22-23 hours per day, though some clinicians allow or encourage removal of the brace for exercise.

Bracing may be appropriate for scoliosis due to some types of neuromuscular disease, including spinal muscular atrophy, before growth is finished. Duchenne muscular dystrophy is not treated by bracing, since surgery is likely to be required, and since later surgery is complicated by loss of respiratory capacity.

Surgery for idiopathic scoliosis is usually recommended if:

  • the curve has progressed despite bracing
  • the curve is greater than 40-50 degrees before growth has stopped in an adolescent
  • the curve is greater than 50 degrees and continues to increase in an adult
  • there is significant pain

Orthopedic surgery for neuromuscular scoliosis is often done earlier. The goals of surgery are to correct the deformity as much as possible, to prevent further deformity, and to eliminate pain as much as possible. Surgery can usually correct 40-50% of the curve, and sometimes as much as 80%. Surgery cannot always completely remove pain.

The surgical procedure for scoliosis is called spinal fusion, because the goal is to straighten the spine as much as possible, and then to fuse the vertebrae together to prevent further curvature. To achieve fusion, the involved vertebra are first exposed, and then scraped to promote regrowth. Bone chips are usually used to splint together the vertebrae to increase the likelihood of fusion. To maintain the proper spinal posture before fusion occurs, metal rods are inserted alongside the spine, and are attached to the vertebrae by hooks, screws, or wires. Fusion of the spine makes it rigid and resistant to further curvature. The metal rods are no longer needed once fusion is complete, but are rarely removed unless their presence leads to complications.

Spinal fusion leaves the involved portion of the spine permanently stiff and inflexible. While this leads to some loss of normal motion, most functional activities are not strongly affected, unless the very lowest portion of the spine (the lumbar region) is fused. Normal mobility, exercise, and even contact sports are usually all possible after spinal fusion. Full recovery takes approximately six months.

Alternative treatment

Numerous alternative therapies have been touted to provide relief and help for individuals with scoliosis, but none have been proven beneficial in clinical trials. These include massage, physical therapy, and electrical stimulation. In addition, alternatives such as physical therapy, rolfing, or chiropractice manipulation may provide improved flexibility, stronger muscles, and pain relief, but cannot prevent or correct the curvature of the spine or its natural progression.

Although important for general health and strength, exercise has not been shown to prevent or slow the development of scoliosis. It may help relieve pain from scoliosis by helping to maintain range of motion. Aquatic exercise, in particular, can increase flexibility and improve posture, balance, coordination, and range of motion. Because it decreases joint compression, it can lessen the pain caused by scoliosis or surgery.

Good nutrition is also important for general health, but no specific dietary regimen has been shown to control scoliosis development. In particular, dietary calcium levels do not influence scoliosis progression.

Chiropractic treatment may relieve pain, but it cannot halt scoliosis development, and should not be a substitute for conventional treatment of progressing scoliosis. Acupuncture and acupressure may also help reduce pain and discomfort, but they cannot halt scoliosis development either.

Prognosis

The prognosis for a person with scoliosis depends on many factors, including the age at which scoliosis begins and the treatment received. More importantly, mostly unknown individual factors affect the likelihood of progression and the severity of the curve. Most cases of mild adolescent idiopathic scoliosis need no treatment and do not progress. Untreated severe scoliosis often leads to spondylosis, and may impair breathing. Degenerative arthritis of the spine, sciatica, and severe physical deformities can also result if severe scoliosis is left untreated. Finally, scoliosis can also poorly affect the individual's self-esteem and cause serious emotional problems.

Prevention

There is no known way to prevent the development of scoliosis. Progression of scoliosis may be prevented through bracing or surgery.

Exercise and physical fitness are of paramount importance for all individuals affected with scoliosis. They not only work to maintain flexibility and health, but decrease the likelihood of osteoporosis, which in these individuals, can be extremely debilitating.

Resources

BOOKS

Lyons, Brooke, et al. Scoliosis: Ascending the Curve. New York: M. Evans & Co., 1999.

PERIODICALS

Bridwell, KH, et al., editors. "Parents' and Patients' Preferences and Concerns in Idiopathic Adolescent Scoliosis: A Cross-Sectional Preoperative Analysis." Spine 25, no. 18 (September 2000): 2392-9.

ORGANIZATIONS

American Physical Therapy Assocation. Scoliosis, P.O. Box 37257, Washington, DC 20013.

Center for Spinal Disorders, PC. 8515 Pearl Street, Suite 350, Thornton, CO 80229. (303) 287-2800; fax: (303) 287-7357. http://www.cntrforspinaldisorders.com.

National Scoliosis Foundation. 72 Mount Auburn St., Watertown, MA 02172. (617) 926-0397.

The Scoliosis Association. PO Box 811705, Boca Raton, FL 33481-0669. (407) 368-8518.

OTHER

"Chiropractic Treatment of Scoliosis." Scoliosis World.

KEY TERMS

Cobb angle A measure of the curvature of scoliosis, determined by measurements made on x rays.

Rolfing A system of soft tissue manipulation and movement education to realign and reorient the body.

Scoliometer A tool for measuring trunk asymmetry; it includes a bubble level and angle measure.

Spondylosis Arthritis of the spine.

Cite this article
Pick a style below, and copy the text for your bibliography.

  • MLA
  • Chicago
  • APA

Meszaros, Liz. "Scoliosis." Gale Encyclopedia of Medicine, 3rd ed.. 2006. Encyclopedia.com. 27 Sep. 2016 <http://www.encyclopedia.com>.

Meszaros, Liz. "Scoliosis." Gale Encyclopedia of Medicine, 3rd ed.. 2006. Encyclopedia.com. (September 27, 2016). http://www.encyclopedia.com/doc/1G2-3451601452.html

Meszaros, Liz. "Scoliosis." Gale Encyclopedia of Medicine, 3rd ed.. 2006. Retrieved September 27, 2016 from Encyclopedia.com: http://www.encyclopedia.com/doc/1G2-3451601452.html

Scoliosis

Scoliosis

Definition

Scoliosis is defined as an abnormal side-to-side or front-to-back curvature of the spine.

Description

When viewed from the rear, the spine usually appears perfectly straight. Scoliosis is a lateral (side-to-side) curve in the spine, usually combined with a rotation of the vertebrae. The lateral curvature of scoliosis should not be confused with the normal set of front-to-back spinal curves visible from the side. While a small degree of lateral curvature does not cause any medical problems, larger curves can cause postural imbalance and lead to muscle fatigue and pain . More severe scoliosis can interfere with breathing and lead to arthritis of the spine (spondylosis).

Approximately 10% of all adolescents have some degree of scoliosis, though fewer than 1% have curves that require medical attention beyond monitoring. Scoliosis is found in both boys and girls, but a girl's spinal curve is much more likely to progress than a boy's. Girls require scoliosis treatment about five times as often. The reason for these differences is not known.

Causes & symptoms

Four out of five cases of scoliosis are idiopathic, meaning that the cause is unknown. Idiopathic scoliosis tends to run in families; genetic screening has identified several different patterns of genetic transmission as of late 2001. In some families, idiopathic scoliosis is transmitted in an autosomal dominant pattern, while in others the mode of inheritance is X-linked. Children with idiopathic scoliosis appear to be otherwise entirely healthy, and have not had any bone or joint disease early in life. Scoliosis is not caused by poor posture, diet, or carrying a heavy book-bag exclusively on one shoulder.

Idiopathic scoliosis is further classified according to age of onset:

  • Infantile. Curvature appears before age three. This type is quite rare in the United States, but is more common in Europe.
  • Juvenile. Curvature appears between ages three and 10. This type may be equivalent to the adolescent type, except for the age of onset.
  • Adolescent. Curvature appears between ages of 10 and 13, near the beginning of puberty. This is the most common type of idiopathic scoliosis.
  • Adult. Curvature begins after physical maturation is completed.

Causes are known for three other types of scoliosis:

  • Congenital scoliosis is due to congenital birth defects in the spine, often associated with other organ defects.
  • Neuromuscular scoliosis is due to loss of control of the nerves or muscles that support the spine. The most common causes of this type of scoliosis are cerebral palsy and muscular dystrophy.
  • Degenerative scoliosis may be caused by degeneration of the discs that separate the vertebrae or arthritis in the joints that link them.

Scoliosis causes a noticeable asymmetry in the torso when viewed from the front or back. The first sign of scoliosis is often seen when a child is wearing a bathing suit or underwear. A child may appear to be standing with one shoulder higher than the other, or to have a tilt in the waistline. One shoulder blade may appear more prominent than the other due to rotation. In girls, one breast may appear higher than the other, or larger if rotation pushes that side forward.

Curve progression is greatest near the adolescent growth spurt. Scoliosis that begins early is more likely to progress significantly than scoliosis that begins later in puberty.

More than 30 states have screening programs in schools for adolescent scoliosis, usually conducted by trained school nurses or physical education teachers.

Diagnosis

Diagnosis for scoliosis is typically continued by an orthopedist. A complete medical history is taken, including questions abouta a family history of scoliosis. The physical examination includes determination of pubertal development in adolescents, a neurological examination (which may reveal a neuromuscular cause), and measurements of trunk asymmetry. Examination of the trunk is done while the patient is standing, bending over, and lying down. The forward bending test is sometimes referred to as the Adams test. It involves both visual inspection and use of a simple mechanical device called a scoliometer.

If a curve is detected, one or more x rays will usually be taken to define the curve or curves more precisely. An x ray is used to document spinal maturity, any pelvic tilt or hip asymmetry, and the location, extent, and degree of curvature. The curve is defined in terms of its beginning and ending points, its direction, and by an angle measure known as the Cobb angle. The Cobb angle is found by projecting lines parallel to the vertebrae tops at the extremes of the curve, projecting perpendiculars from these lines, and measuring the angle of intersection. To properly track the progress of scoliosis, it is important to project from the same points of the spine each time.

Occasionally, magnetic resonance imaging (MRI) is used, primarily to look more closely at the condition of the spinal cord and nerve roots extending from it if neurological problems are suspected.

Treatment

Although important for general health and strength, exercise has not been shown to prevent or slow the progression of scoliosis. It may help to relieve pain from scoliosis by helping to maintain range of motion. Good nutrition is also important for general health, but no specific dietary regimen has been shown to control scoliosis development. In particular, dietary calcium levels do not influence scoliosis progression.

Chiropractic treatment may relieve pain but cannot halt scoliosis development, and should not be a substitute for conventional treatment of progressive scoliosis. Acupuncture and acupressure may also help reduce pain and discomfort, but they cannot halt scoliosis development either.

Other movement therapies (yoga, t'ai chi, qigong , and dance) improve flexibility and are useful when used with such movement education therapies as Feldenkrais , the Rosen method , the Alexander technique , and Pilates .

Allopathic treatment

Treatment decisions for scoliosis are based on the degree of curvature, the likelihood of significant progression, and the presence of pain, if any.

Curves less than 20° are not usually treated, except by regular follow-up for children who are still growing. Watchful waiting is usually all that is required in adolescents with curves of 2030°, or adults with curves up to 40° or slightly more, as long as there is no pain.

For children or adolescents whose curves progress to 30°, and who have a year or more of growth left, bracing may be required. Bracing cannot correct curvature but may be effective in halting or slowing progression. Bracing is rarely used in adults, except where pain is significant and surgery is not an option, as in some elderly patients.

Two general styles of braces are used for daytime wear. The Milwaukee brace consists of metal uprights attached to pads at the hips, rib cage, and neck. The under-arm brace uses rigid plastic to encircle the lower rib cage, abdomen, and hips. Both of these brace types hold the spine in a vertical position. Because it can be worn out of sight beneath clothing, the underarm brace is better tolerated and often leads to better compliance. A third style, the Charleston bending brace, is used at night to bend the spine in the opposite direction. Braces are often prescribed to be worn for 2223 hours per day, though some clinicians allow or encourage removal of the brace for exercise.

Bracing may be appropriate for scoliosis due to some types of neuromuscular disease, including spinal muscular atrophy, before growth is finished. Duchenne muscular dystrophy is not treated by bracing, since surgery is likely to be required and later surgery is complicated by loss of respiratory capacity.

Surgery for idiopathic scoliosis is usually recommended if:

  • The curve has progressed despite bracing.
  • The curve is greater than 4050° before growth has stopped in an adolescent.
  • The curve is greater than 50° and continues to increase in an adult.
  • There is significant pain.

Orthopedic surgery for neuromuscular scoliosis is often done earlier. The goals of surgery are to correct the deformity as much as possible, to prevent further deformity, and to eliminate pain as much as possible. Surgery can usually correct 4050% of the curve, sometimes as much as 80%. Surgery cannot always completely remove pain.

The surgical procedure for scoliosis is called spinal fusion, because the goal is to straighten the spine as much as possible, and then to fuse the vertebrae together to prevent further curvature. To achieve fusion, the involved vertebra are first exposed, and then scraped to promote regrowth. Bone chips are usually used to splint together the vertebrae to increase the likelihood of fusion. To maintain the proper spinal posture before fusion occurs, metal rods are inserted alongside the spine and attached to the vertebrae by hooks, screws, or wires. Fusion of the spine makes it rigid and resistant to further curvature. The metal rods are no longer needed once fusion is complete but are rarely removed unless their presence leads to complications.

Spinal fusion leaves the involved portion of the spine permanently stiff and inflexible. While this stiffness leads to some loss of normal motion, most functional activities are not strongly affected, unless the very lowest portion of the spine (the lumbar region) is fused. Normal mobility, exercise, and even contact sports are usually all possible after spinal fusion. Full recovery takes approximately six months.

Expected results

The prognosis for a person with scoliosis depends on many factors, including the age at which scoliosis begins and the treatment received. More importantly, mostly unknown individual factors affect the likelihood of progression and the severity of the curve. Most cases of mild adolescent idiopathic scoliosis need no treatment and do not progress. Untreated severe scoliosis often leads to spondylosis and may impair breathing.

Prevention

There is no known way to prevent the development of scoliosis. Progression of scoliosis may be prevented through bracing or surgery.

Resources

BOOKS

Neuwirth, Michael, and Kevin Osborn. The Scoliosis Handbook. New York: Henry Holt & Co., 1996.

PERIODICALS

Justice, C.M., N. H. Miller, B. Marosy, et al. "Genetic Heterogeneity Comprising Both X-Linked and Autosomal Dominant Forms of Inheritance in Families with Familial Idiopathic Scoliosis." American Journal of Human Genetics 69 (October 2001): 384.

Splete, Heidi. "Catch Curves Like Scoliosis in Time for Bracing (Watch Your Patients' Backs)." Pediatric News 35 (November 2001): 4243.

ORGANIZATIONS

National Scoliosis Foundation. 5 Cabot Place Stoughton, MA 02072. (800) 673-6922. NSF@scoliosis.org. <http://www.scoliosis.org>.

The Scoliosis Association. PO Box 811705 Boca Raton, FL 33481-1705. (407) 368-8518. normlipin@aol.com. <http://www.scoliosis-assoc.org>.

Scoliosis Research Society. 611 East Wells Street Milwaukee, WI 53202. (414) 289-9107. Tjackson@execinc.com. <http://www.srs.org>.

Paula Ford-Martin

Rebecca J. Frey, PhD

Cite this article
Pick a style below, and copy the text for your bibliography.

  • MLA
  • Chicago
  • APA

Ford-Martin, Paula; Frey, Rebecca. "Scoliosis." Gale Encyclopedia of Alternative Medicine. 2005. Encyclopedia.com. 27 Sep. 2016 <http://www.encyclopedia.com>.

Ford-Martin, Paula; Frey, Rebecca. "Scoliosis." Gale Encyclopedia of Alternative Medicine. 2005. Encyclopedia.com. (September 27, 2016). http://www.encyclopedia.com/doc/1G2-3435100703.html

Ford-Martin, Paula; Frey, Rebecca. "Scoliosis." Gale Encyclopedia of Alternative Medicine. 2005. Retrieved September 27, 2016 from Encyclopedia.com: http://www.encyclopedia.com/doc/1G2-3435100703.html

Scoliosis

SCOLIOSIS

DEFINITION


Scoliosis (pronounced SKO-lee-OH-siss) is a side-to-side curvature of the spine (backbone).

DESCRIPTION


When viewed from the back, the spine usually appears perfectly straight. In some cases, however, the spine is curved rather than straight. In addition, the vertebrae (the bones that make up the spinal column) are twisted. This condition is known as scoliosis.

A small degree of curving in the spine does not usually cause any medical problems. But larger curves can lead to certain disorders, such as posture imbalance, muscle fatigue, and back pain. Severe scoliosis can interfere with breathing and lead to spondylosis (arthritis of the spine; pronounced spon-dl-OH-siss).

About 10 percent of all adolescents have some degree of scoliosis. Less than 1 percent, however, require medical attention other than careful observation of the problem. Scoliosis occurs in both sexes, but appears in girls about five times more often than in boys. Scoliosis appears most often in adolescents between the age of ten and thirteen.

Scoliosis: Words to Know

Cobb angle:
A measure of the curvature of the spine, determined from measurements made on X-ray photographs.
Magnetic Resonance Imaging (MRI):
A procedure that uses electromagnets and radio waves to produce images of a patient's internal tissue and organs. These images are not blocked by bones, and can be useful in diagnosing brain and spinal disorders and other diseases.
Scoliometer:
A tool for measuring the amount of curvature in a person's spine.
Spondylosis:
Arthritis of the spine.

CAUSES


Scoliosis is not caused by poor posture, diet, or carrying heavy objects. The cause of scoliosis is known in only about 20 percent of all cases. These cases are classified as follows:

  • Congenital scoliosis is caused by defects in the spine present at birth. This form of scoliosis is also accompanied by other disorders of various organs.
  • Neuromuscular scoliosis is caused by problems with the nerves or muscles. They are unable to support the spine in its normal position. The most common causes of this type of scoliosis are cerebral palsy (see cerebral palsy entry) and muscular dystrophy (see muscular dystrophy entry).
  • Degenerative scoliosis is caused by deterioration of the bony material (discs) that separate the vertebrae. Arthritis in the spinal cord can also lead to degenerative scoliosis.

In four out of five scoliosis cases, however, the cause is unknown. Such cases are known as idiopathic scoliosis. Children with idiopathic scoliosis have not suffered from related disorders such as bone or joint disease early in life. Some researchers believe that the condition may be inherited, but scientists have yet to find a gene responsible for the disease.

SYMPTOMS


Scoliosis causes a curvature in the upper body that is easy to notice from the front or back. The curvature may be noticed when a child is wearing a bathing suit or underwear. The child may appear to be standing with one shoulder higher than the other, or one shoulder blade may be pushed forward because the body has been rotated by scoliosis.

The amount of curvature increases during the adolescent years. During this period, a person's bones are growing and developing. Any curvature present before adolescence is likely to become more pronounced. As a result, cases of scoliosis that begin early in life tend to get worse than those that develop later in life.

More than thirty states have set up screening programs for scoliosis. A screening program is a plan for the detection of some specific medical problem.

DIAGNOSIS


Diagnosis for scoliosis is usually done by an orthopedist. An orthopedist is a doctor who specializes in bones and joints. The orthopedist normally takes a complete medical history and conducts a physical examination. In the medical history, the orthopedist attempts to find out whether scoliosis has been present in other family members.

One purpose of the medical examination is to look for specific physical causes for the scoliosis. For example, the doctor might look for nerve or muscle disorders that might cause the problem.

A major part of the examination involves a careful observation of the patient's upper body. The patient may be asked to stand, bend over, and lie down. The doctor is able to study the patient's spine in all of these positions. A simple device called a scoliometer can be used to determine the extent to which the spine is curved.

The most conclusive diagnosis of scoliosis is based on X rays. An X ray of the back shows exactly where and how much the spine is curved. The doctor can make very precise calculations from the X-ray photograph to determine a measurement known as the Cobb angle. The Cobb angle combines all of the data provided by an X-ray photograph to determine the extent of a person's scoliosis.

Occasionally, magnetic resonance imaging (MRI), which uses electro-magnets and radio waves to produce images of a patient's internal tissue and organs, can be used in the diagnosis of scoliosis. MRI shows the condition of the spinal cord and the nerves extending from it. It can be used to tell if problems with the nervous system are responsible for the scoliosis.

TREATMENT


A number of factors determine the kind of treatment for scoliosis. These factors include the amount of curvature, the likelihood of improvement, and the amount of pain that may be involved, if any.

Observation

A perfectly straight spine is said to have a curvature of 0 degrees. Children who have curvature of less than 20 degrees usually do not receive any form of treatment.

In many cases, the only medical attention required for scoliosis is careful observation over time. This observation allows doctors to decide whether some form of treatment may be necessary or not. Observation is usually used with adolescents whose spine has a curvature of 20 to 30 degrees. It is also used with adults with a curvature as high as 40 degrees, as long as there is no pain.

Bracing

In more serious cases of curvature, a procedure known as bracing may be used. Bracing is a method of treatment in which the upper body is held in position by metal rods. Three types of bracing are used for scoliosis:

  • The Milwaukee brace consists of metal rods attached to pads at the hips, rib cage, and neck.
  • The underarm brace uses rigid plastic to surround the lower rib cage, abdomen, and hips.
  • The Charleston bending brace is used at night to bend the spine in the opposite direction.

Braces are usually worn for twenty-two to twenty-four hours each day. Bracing is used with children or adolescents whose curvature is greater than 30 degrees and who are expected to grow for at least another year.

The procedure cannot correct curvature that has already occurred. But it can help to prevent the problem from getting worse. Bracing is seldom used with adults. Two situations in which it may be used are with people who suffer great pain and those who cannot undergo surgery.

Surgery

Scoliosis can also be treated with surgery. Surgery is usually recommended under the following conditions:

  • The curvature has progressed despite bracing.
  • The curvature is greater than 40 to 50 degrees before growth has stopped in an adolescent.
  • The curvature is greater than 50 degrees and continues to increase in an adult.
  • The patient is in significant pain.

Surgery for neuromuscular surgery is often done earlier. The three goals of surgery are to correct the curvature as much as possible, to prevent further curvature, and to relieve pain. Surgery can usually correct 40 to 50 percent of the curvature, and sometimes as much as 80 percent. It is not always successful in completely removing pain.

The surgical procedure for scoliosis is called spinal fusion. The goal of this procedure is first to straighten the spine as much as possible. Then, the vertebrae are joined together to prevent further curvature.

The first step in spinal fusion is to uncover the vertebrae in the region of curvature. These vertebrae are then scraped clean to produce smooth surfaces. The vertebrae are then joined to each other. When joined in this way, the vertebrae eventually grow together. Metal rods are then inserted along the spine. The vertebrae are attached to the rods with hooks, screws, or wires. The rods hold the spine in position until the vertebrae grow together.

Spinal fusion leaves the involved section of the spine permanently stiff and inflexible. A person no longer has a full range of motion. However, most activities are usually not affected by this change. Normal mobility (movement), exercise, and even contact sports are possible after spinal fusion. Full recovery following spinal fusion takes about six months.

Alternative Treatment

Exercise may help relieve the pain of scoliosis. However, it has no effect on the overall development of the disorder. Good nutrition is also helpful in maintaining a healthy body. But nutrition also has no effect on the progression of scoliosis.

Chiropractic treatment can sometimes relieve the pain of scoliosis. But it does not stop or slow down the progress of the disorder. It also should not be used in place of standard medical treatments. Acupuncture and acupressure may also help reduce and pain and discomfort, but have no effect on the disorder itself.

PROGNOSIS


The prognosis for a person with scoliosis depends on many factors. One of the most important factors is the age at which scoliosis begins. Another factor is the kind of treatment used and the stage at which it was started. Probably the most important factors of all are those beyond the control of medical science, that is, the unknown factors that produce scoliosis in the first place.

Most cases of mild adolescent idiopathic scoliosis need no treatment and do not progress. Untreated severe scoliosis may lead to arthritis of the spine and impair breathing.

PREVENTION


There is no known way to prevent scoliosis. Bracing or surgery, however, can prevent the disorder from progressing.

FOR MORE INFORMATION


Books

Eisenpreis, Bettijane. Coping With Scoliosis. New York: Rosen Publishing Group, 1999.

Neuwirth, Michael, and Kevin Osborn. The Scoliosis Handbook. New York: Henry Holt & Co., 1996.

Schommer, Nancy. Stopping Scoliosis: The Complete Guide to Diagnosis and Treatment. Garden City Park, NY: Avery Publishing Group, 1991.

Organizations

National Scoliosis Foundation, 72 Mount Auburn St., Watertown, MA 02172. (617) 9260397.

Scoliosis Research Society. 6300 N. River Rd., Suite 727, Rosemont, IL 600184226. (708) 6981627.

The Scoliosis Association. P.O. Box 811705, Boca Raton, FL 334810669. (407) 3688518.

Cite this article
Pick a style below, and copy the text for your bibliography.

  • MLA
  • Chicago
  • APA

"Scoliosis." UXL Complete Health Resource. 2001. Encyclopedia.com. 27 Sep. 2016 <http://www.encyclopedia.com>.

"Scoliosis." UXL Complete Health Resource. 2001. Encyclopedia.com. (September 27, 2016). http://www.encyclopedia.com/doc/1G2-3437000228.html

"Scoliosis." UXL Complete Health Resource. 2001. Retrieved September 27, 2016 from Encyclopedia.com: http://www.encyclopedia.com/doc/1G2-3437000228.html

Scoliosis

Scoliosis

What Is Scoliosis?

Causes, Known and Unknown

What Are the Signs and Symptoms of Scoliosis?

How Do Doctors Diagnose and Treat Scoliosis?

Living with Scoliosis

Resources

Scoliosis (sko-lee-O-sis) is a lateral, or side-to-side, curvature of the spine that most often occurs gradually during childhood or adolescence.

KEYWORDS

for searching the Internet and other reference sources

Back pain

Orthopedics

Skeletal system

Spine

Vertebrae

What Is Scoliosis?

The name scoliosis comes from the Greek word meaning curvature. Everyones backbone curves to some degree from front to back, which is necessary for proper movement and walking. In scoliosis, however, the spine curves in a side-to-side direction too, or the curve may be S-shaped when another part of the spine develops a counterbalancing secondary curve. Depending on the degree of curvature, this may cause other physical problems, such as pain and breathing difficulties. The parts of the spine most commonly involved are the thoracic (tho-RAS-ik), or chest region, and the lumbar (LUM-bar), or lower back region.

Scoliosis is a fairly common condition. It has been estimated that about 3 out of every 100 people have this disorder to some degree. Girls are about 5 times more likely than boys to develop scoliosis.

Causes, Known and Unknown

The most common form of scoliosis is called idiopathic (id-ee-o-PATH-ik), which means that the cause is unknown. Usually, scoliosis becomes apparent just prior to or during adolescence, when the bodys rate of growth speeds up markedly. The curvature stops increasing after people have reached their mature height.

Rarely, scoliosis is a congenital (present at birth) abnormality of the vertebrae (VER-te-bray), or spinal bones, and continues to develop throughout childhood. Poliomyelitis (po-le-o-my-e-LY-tis) has caused scoliosis in some people by paralyzing or weakening the spinal muscles on one side of the body.

Occasionally, an injury such as a disk prolapse (slipped disk) or a sprained ligament* in the backbone can cause temporary scoliosis. When this happens, the curvature may be accompanied by back pain and sciatica*.

* ligament
(LIG-a-ment) is a fibrous band of tissue that connects bones or cartilages (CAR-ti-lij-ez), serving to support or strengthen joints.
* sciatica
(sy-AT-l-ka) is pain along the course of either of the sciatic (sy-AT-ik) nerves, which run through the pelvis and down the backs of the thighs.

People who have scoliosis often have family members with the same condition. This suggests that heredity also is a causal factor in some cases of scoliosis.

What Are the Signs and Symptoms of Scoliosis?

Because scoliosis can develop very gradually, there may be no observed signs or symptoms in its early stages. Often, the curvature is first noticed in a teenager indirectly: one shoulder may become noticeably higher than the other, or a dress or jacket may not hang straight.

Early symptoms of scoliosis may include an unusually tired or achy feeling in the lower back after standing or sitting for a long time.

For some, the curvature eventually may become more severe and easier to recognize. Severe scoliosis can cause chronic* back pain. If the curvature exceeds an angle of about 40 or 45 degrees, it can interfere with breathing and affect heart function.

* chronic
(KRON-ik) means continuing for a long period of time.

How Do Doctors Diagnose and Treat Scoliosis?

Diagnosis

Scoliosis is not always easy to diagnose, especially if it does not hurt or have visible signs. A physical examination of the spine, hips, and legs is the first step, followed by an x-ray if needed.

Back Braces, Past and Present

A hundred years ago, teenagers who had to wear back braces for scoliosis faced some very uncomfortable choices. As if being tortured, they were strapped to racks in an attempt to straighten their backs. Later on, metal jackets that weighed up to 30 pounds were worn to try to reduce the curvature. Lighter jackets, made of plaster of paris, came next, but often they were hot and itchy.

Todays back braces are big improvements. Many are made of lightweight materials and do not have to be worn all the time. There are several different types to choose from to suit the teenagers particular requirements. Some are worn only while sleeping; others can be worn under clothing, so that they are not visible. Still others are of a low-profile type that comes up under the arms and are quite comfortable.

Wearing a back brace sometimes causes emotional problems. Some teenagers may resist the idea of wearing a back brace, because they fear their friends or classmates may reject or ridicule them. Counseling or support groups often are helpful in sharing experiences and problems and should be considered as part of the treatment.

Tomorrows back braces undoubtedly will be even more adaptable, as medical engineers are constantly making improvements.

In the United States, public schools often do a simple test for scoliosis called the forward-bending test. The school nurse or another staff member has students bend over parallel to the floor with their shirts off to check for curvature. If scoliosis is suspected, the student is referred to a family doctor for further evaluation. The doctor might want to have an x-ray taken for a clearer view of the spine.

The severity of scoliosis is diagnosed by determining the extent of curvature of the spine. The curvature is the angle of slant of the spinal bones measured in degrees.

Treatment Choices

If the cause of scoliosis is known, such as an injury or unequal leg length, the treatment is designed to address the cause. For example, wearing a shoe with a raised heel can correct scoliosis caused by unequal leg length.

In idiopathic scoliosis, however, the choice of treatment depends largely on the severity of the condition. If the angle of curvature is slight (say, 10 to 15 degrees) nothing may need to be done other than having regular checkups to make sure the curvature does not worsen. Somewhat greater curvature can be treated by wearing any of several types of back braces. An angle of curvature of 40 degrees or more may mean that a corrective operation will be needed.

Living with Scoliosis

Fortunately, much of the deformity of scoliosis can be prevented if the condition is detected early. In most instances, no lifestyle changes are needed, and people can carry on with their normal activities.

See also

Sciatica

Slipped Disk

Resources

The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), part of the U.S. National Institutes of Health (NIH), posts information about scoliosis on its website. http://www.nih.gov/niams/healthinfo/scochild.htm

The Nemours Foundation posts a fact sheet about scoliosis at its website. http://kidshealth.org/teen/bodymind/scoliosis.html

The Southern California Orthopedic Institute also has a helpful website. http://www.scoi.com/scoilio.htm

Cite this article
Pick a style below, and copy the text for your bibliography.

  • MLA
  • Chicago
  • APA

"Scoliosis." Complete Human Diseases and Conditions. 2008. Encyclopedia.com. 27 Sep. 2016 <http://www.encyclopedia.com>.

"Scoliosis." Complete Human Diseases and Conditions. 2008. Encyclopedia.com. (September 27, 2016). http://www.encyclopedia.com/doc/1G2-3497700341.html

"Scoliosis." Complete Human Diseases and Conditions. 2008. Retrieved September 27, 2016 from Encyclopedia.com: http://www.encyclopedia.com/doc/1G2-3497700341.html

scoliosis

sco·li·o·sis / ˌskōlēˈōsis/ • n. Med. abnormal lateral curvature of the spine. DERIVATIVES: sco·li·ot·ic / -ˈätik/ adj.

Cite this article
Pick a style below, and copy the text for your bibliography.

  • MLA
  • Chicago
  • APA

"scoliosis." The Oxford Pocket Dictionary of Current English. 2009. Encyclopedia.com. 27 Sep. 2016 <http://www.encyclopedia.com>.

"scoliosis." The Oxford Pocket Dictionary of Current English. 2009. Encyclopedia.com. (September 27, 2016). http://www.encyclopedia.com/doc/1O999-scoliosis.html

"scoliosis." The Oxford Pocket Dictionary of Current English. 2009. Retrieved September 27, 2016 from Encyclopedia.com: http://www.encyclopedia.com/doc/1O999-scoliosis.html

scoliosis

scoliosis (skoh-li-oh-sis) n. lateral (sideways) deviation of the backbone, caused by congenital or acquired abnormalities of the vertebrae, muscles, and nerves. See also kyphosis, kyphoscoliosis.

Cite this article
Pick a style below, and copy the text for your bibliography.

  • MLA
  • Chicago
  • APA

"scoliosis." A Dictionary of Nursing. 2008. Encyclopedia.com. 27 Sep. 2016 <http://www.encyclopedia.com>.

"scoliosis." A Dictionary of Nursing. 2008. Encyclopedia.com. (September 27, 2016). http://www.encyclopedia.com/doc/1O62-scoliosis.html

"scoliosis." A Dictionary of Nursing. 2008. Retrieved September 27, 2016 from Encyclopedia.com: http://www.encyclopedia.com/doc/1O62-scoliosis.html

Facts and information from other sites