Have you actually watched “The Hunchback of Notre Dame”? If you did watch it or know about it, you probably remember the main character who has a hunchback. In reality, a person can have such problems due to spine issues. There can be several diseases affecting the normal curve of the spine. Regular health screening may actually help to detect these issues early on. In this article, we will be learning about one of the diseases causing the normal curve of the spine to be abnormal, known as scoliosis.
Scoliosis is a sideway curve of the spine or abnormal lateral curvature of the spine. It is normal for the spine to have curves but when it is looked from behind, the spine appears straight. The spine’s normal curves occur at the cervical (neck), thoracic (chest) and lumbar (hips) regions in the so-called sagittal plane. The Sagittal plane divides the body to right and left halves. These natural curves position the head over the pelvis and work as shock absorbers. As shock absorbers, it works by absorbing the tension or mechanical stress during body movement. In scoliosis, the curve of the spine would be S-shaped or C-shaped which is abnormal for humans.
Scoliosis can develop in young children but usually can be seen prominently when a person reaches 10 and older. Females are 8 times more likely to progress into severe scoliosis that do need treatment. A person is likely to have scoliosis if there is family history of scoliosis such as parents or siblings who have been diagnosed with scoliosis. Scoliosis can be caused by several reasons but about 80% of the cases are with unknown causes (idiopathic). Causes include abnormalities of the spine present at birth and due to neurological or muscular diseases such as cerebral palsy, spinal cord trauma, spina bifida, muscular dystrophy and spinal muscular atrophy. Scoliosis caused by neuromuscular diseases often progresses rapidly compared to idiopathic causes and most likely need surgical treatment.
There are symptoms or signs that may indicate a person with scoliosis. If you or someone you know experience any of the symptoms or signs, it is best to get medical advice by meeting a doctor. Common symptoms includes uneven shoulder with one or both shoulder blades visible or sticking out, one or both hips appeared unusually high, rib cages of different heights, uneven waist, head is not on the same centre as above the pelvis and appearance or skin texture more on the spine changes such as airy patches, colour abnormalities or dimples. The entire body may seem to be leaning to one side. Back pain or back discomfort may occur with scoliosis. In some cases, scoliosis may even affect pulmonary function that may lead to breathing difficulties.
One way a person can simply see if they do have scoliosis is by using a scoliometer. Scoliometer is often confused with Cobb angle as both do report degrees of the spine. Hence, if you wonder if a scoliometer measures Cobb angle, the answer is no it does not. Scoliometer is an instrument with a small level and ruler side with an internal bubble that moves to measure the degree of vertebral rotation and rib arch. Scoliometer is placed on the back of the peak (apex) of the curve and moved in the up and down direction of the spine. The tilt is measured in degrees. Scoliometer measurement taken at the curve’s apex of more than 7 degrees is considered abnormal and patients need to go for further tests such as imaging tests using X-ray and to evaluate Cobb angle.
Cobb angle on the other hand is used to measure the spine curvature by using the full spine x-ray. The angle is measured by using a protractor on a hard copy radiograph or digitally on a computer screen. Cobb angle is the sum of the upper and lower end of the vertebra tilt angle. The angle measurement can help doctors know the severity of the scoliosis. A cobb angle of more than 10 degrees can be considered as scoliosis. Cobb angle and scoliometer can be confusing for new patients with scoliosis as they both report degrees but it is worth noting that the degrees reading and interpretation can be different. This may affect a patient’s understanding of the severity of the scoliosis and the progression.
Treatment for scoliosis depends on the severity of the scoliosis. In most cases, there is no need for surgery and only observation is needed. This means a child may need to get checked by a doctor for every 4 to 6 months and adults are recommended to take x-ray test once every five years. Surgery is usually needed when the spinal curve is greater than 40 degrees with signs of progression. In children, bracing may be considered to stop the curve from progressing.
In essence, scoliosis is more than just the abnormality of the spine. It can affect a person’s quality of life since a person may feel constant back pain and even breathing issues. Scoliometer and Cobb angle do measure degrees of the tilt spine but scoliometer should only be considered as screening tool whereas Cobb angle is the diagnostic tool confirming a scoliosis. Talk to your healthcare provider if you have enquiries regarding scoliosis.