There are many causes of scoliosis deformity but the most common type of scoliosis is idiopathic scoliosis (IS) which affects about 80% of all scoliosis patients. The term idiopathic literally means that the cause of the scoliosis deformity is unknown (Kleinberg 1922).
There are 4 chronological sub groups of idiopathic scoliosis as proposed by the Society on Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT). The sub groups are determined by the age at which the first scoliosis features were diagnosed:
- Infantile idiopathic scoliosis - 0 to 3 years
- Juvenile idiopathic scoliosis - 3 to 10 years
- Adolescent idiopathic scoliosis - 10 to 18 years
- Adult idiopathic scoliosis – 18 years & over
Idiopathic scoliosis (IS) can progress during periods of rapid growth in childhood and particularly in adolescence, and again later in adult life. Adolescent bracing is usually recommended to prevent further progression once the curve has progressed above a Cobb angle of 25 degrees.
The following 2 images show that the radiological characteristics evident in the x-ray image confirms the clinical observations of the photo image.
Excluding scoliosis that develops early in life or from a separate syndrome there are 2 types of adult scoliosis: Adult idiopathic scoliosis which is a progression of the scoliosis from adolescence where curves have since worsened due to disc degeneration and possibly sagittal imbalance; and Adult degenerative scoliosis, also known as de novo (new) scoliosis which starts in adult life due to disc degeneration, arthritis of facet joints and other factors.
Today, Scoliosis is known as a three dimensional deformity of the spine involving a forward, sideways, and rotational movement of the involved vertebrae. X-rays will show these vertebra at the centre of the major curve to be wedge shaped in appearance. Bony changes in the vertebrae indicate the scoliosis is structural; these changes, together with soft tissue imbalances cause a trunk deformity.
Once the curve has begun, a 'Vicious Cycle' of asymmetrical gravitational loading begins. As the vicious cycle takes hold it causes: more changes in the deformed vertebrae; further progression of the curve, which looses its flexibility; and further changes in trunk deformity.
At this point in time there is no cure for scoliosis but it can be managed in active daily life to maintain good (symmetrical) posture and optimal health. The Schroth Method of scoliosis-specific exercises are designed to help individuals better manage their scoliosis throughout their lifetime.
For information about adolescent bracing in Australia, internationally recognized and widely accepted rigid asymmetrical 3D Chêneau style braces, such as the Gensingen brace™ and RSC®) brace, are now available in Australia.
Schroth Method scoliosis-specific exercises can improve the effectiveness of adolescent bracing.