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Daily Archives: July 6, 2013

Children and Scoliosis

By |July 6, 2013|Pediatrics, Scoliosis|

Children and Scoliosis

The Chiro.Org Blog

SOURCE:   Dynamic Chiropractic

By Kim Christensen, DC, DACRB, CCSP, CSCS

Scoliosis is defined as “any lateral deviation of the spine from the mid-sagittal plane.” [1]

While there are many causes for scoliosis, children and adolescents with scoliosis who present to chiropractors usually fall into three categories.

Successful treatment is dependent upon differentiating the underlying cause of the spinal curvature. In most children, the scoliotic spine is not symptomatic; the spinal curvature is first noticed either by a parent who becomes concerned about a child’s posture, or during a screening examination, usually at school. The importance of a good evaluation and early treatment is to prevent progression and worsening of the curvature. Children with all three major causes of scoliosis should have a careful evaluation of the lower extremities as part of their spinal examination to determine associated or contributing components to the spinal deviation.

  1. Structural vs. Nonstructural Scoliosis   A structural scoliosis is defined as a spinal curvature that does not correct during recumbent, lateral flexion radiographs. The two most common causes of a structural scoliosis are congenital and idiopathic. A nonstructural scoliosis can be reduced when lying down, and will correct with recumbent lateral flexion. This type of spinal curvature is sometimes called a “functional curve,” and is often secondary to a leg length discrepancy.

  2. Congenital Scoliosis   Of the three major etiologies of scoliosis, this is the least common. Congenital scoliosis develops secondary to a bony anomaly of the sacrum, vertebrae or ribs. These are often defects of formation or segmentation, resulting in wedged, blocked, or hemi-vertebrae. In some cases, the abnormality will require corrective surgery. In many children, a heel lift or shoe buildup can provide sufficient structural support, and help to maintain a balanced spine.

    When a congenital spinal anomaly is discovered, it’s important to remember that there are usually multiple affected areas. For instance, it is more common to have multiple bony abnormalities than just a single level. Nonosseous and extraspinal deformities are also often present. These may include the cartilaginous and connective tissues, and even genitourinary or cardiovascular abnormalities. Clubfoot, a congenitally dislocated hip, or an anatomically short leg often will contribute to the spinal imbalance.

  3. Idiopathic Scoliosis   Idiopathic scoliosis can be progressive, worsening significantly during periods of rapid growth. In the more severe cases, bracing, or possibly surgery, may be necessary to prevent substantial deformity. [2] After skeletal maturity, most curvatures progress only slowly, if at all. Recent scientific research has focused on hormonal and neurological causes for idiopathic scoliosis, with some promising early results, but no definitive conclusions.

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