Scoliosis

Scoliosis is a sideways curvature of the spine that is greater than 10° (Cobb angle), this is measured on an x-ray. It can occur at any age, but most often occurs in children and teenagers. The curve usually creates an “S” or “C” shape of the spine. The curve also causes the spinal vertebrae to rotate. In some cases, the scoliosis is stable, while others can increase over time. Mild scoliosis does not usually cause issues, but severe cases can be very problematic. 


CLASSIFICATION

• Idiopathic. Idiopathic means a condition not associated with any other disease or disorder. There are 3 main types:
  • Infantile – curvature develops before the age of two and will usually spontaneously resolve. This type is rare in Australia.
  • Juvenile – curvature develops between two and ten years. Also rare in Australia
  • Adolescent – curvature appears during early adolescence. 
• Non-idiopathic (De novo scoliosis, syndromal, pathological scoliosis)

PREVALENCE + EPIDEMIOLOGY

• Prevalence of Scoliosis increases with age:
  • 0.3% - 0.5% in children.
  • 2% - 4% above the age of 18 years.
  • 9% in over 40-years old.
  • 35.5%+ in over 60-year old.
  • 50 – 68%+ in over 90-year old.

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• Scoliosis affects 2-3% of the US population, which is around 5 to 9 million cases.

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• Adolescent idiopathic scoliosis is the most prevalent form of spinal deformity (0.47-5.2% of adolescents (10-17 years))

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• Females to males = 10:1 (adolescent idiopathic scoliosis)

​CAUSES
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More than 65% of scoliosis cases are idiopathic (unknown cause) but it is generally believed to be multifactorial with genetics and environment being the main contributors. There are many other causes of scoliosis including:
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• Congenital spine deformities (present at birth) (15%).
• Genetic conditions.
• Neuromuscular issues (10%).
• Leg length differences.
• Cerebral palsy.
• Tumours.

SYMPTOMS

Symptoms will vary with each individual and may include:

• Uneven height of shoulders.
• Waist crease are uneven.
• Scapular winging on one side (shoulder blade more prominent than the other).
• One hip higher than the other.
• Uneven musculature.
• Head not centred directly above pelvis.
• Rib prominence when bent over.
• Obvious exaggerated curvature of the spine.
• Back pain or discomfort.

ADOLESCENT VS ADULT

• Adolescent:
  • Highly progressive.
  • Often flexible.
  • Pain not main issue.
  • Correction primary goal.
• Adult:
  • Slowly progressing.
  • Pain is the main issue.
  • Usually rigid.
  • Limited amount of correction.

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TREATMENT/MANAGEMENT

• Observation:
  • The greater the cobb angle, the greater risk of progression during pubertal growth:
    • 5° curve = 10% risk of progression.
    • 10° = 20% risk of progression.
    • 20° = 30% risk of progression.
    • 30° = 100% risk of progression.

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• The main goals of treatment:
  • Prevent curve progression at puberty.
  • Prevent/treat respiratory dysfunction.
  • Prevent/treat spinal pain.
  • Improve aesthetics.

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• Physio-therapeutic scoliosis specific exercise (PSSE)

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• Bracing:
  • Soft-bracing
  • Night-time rigid bracing
  • Part-time rigid bracing (12-20 hours per day)
  • Full-time rigid bracing (20-24 hours per day)

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• Casting?

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• Conservative care such as physical therapy and chiropractic.

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• Surgery
  
  
  

If you would like further information about scoliosis or any other back issue, we recommend consulting your local health practitioner. If you’re local to health associates we would be more than happy to help you. 


REFERENCES

Negrini, S., et al. "SOSORT guidelines: orthopaedic and rehabilitation treatment of idiopathic scoliosis during growth. Scoliosis Spinal Disord 13: 3." (2016).

Schwab, Frank, et al. "Adult scoliosis: prevalence, SF-36, and nutritional parameters in an elderly volunteer population." Spine 30.9 (2005): 1082-1085.

Weinstein, Stuart L., et al. "Adolescent idiopathic scoliosis." The Lancet 371.9623 (2008): 1527-1537.

Konieczny, Markus Rafael, Hüsseyin Senyurt, and Rüdiger Krauspe. "Epidemiology of adolescent idiopathic scoliosis." Journal of children's orthopaedics 7.1 (2012): 3-9.

Noshchenko, Andriy, et al. "Predictors of spine deformity progression in adolescent idiopathic scoliosis: A systematic review with meta-analysis." World journal of orthopedics 6.7 (2015): 537.

Soucacos, Panayotis N., et al. "Risk factors for idiopathic scoliosis: review of a 6-year prospective study." Orthopedics23.8 (2000): 833-838.

Joshua Hallinan
Chiropractor

Joshua is a very focused, dedicated and committed Practitioner.  

Growing up in Menai, he has been actively involved in  AFL and Cricket and  currently has a passion for Soccer and strength based training. He loves sport but more importantly, Joshua can see the major benefits of being active and moving regularly.

Joshua's special interests are in sports injuries, musculoskeletal complaints and headaches. He enjoys helping relieve pain and alignments and supporting his patients to live optimally as well as instilling optimism and personal belief that moving well is important for a happy and health life.

You know when you see Joshua you are in the hands of someone who continually strives to be ahead in his profession and will bring his expertise and skill to all of his patients. You'll find Josh has a friendly and enthusiastic personality, who is also very relaxed and down to earth to be with, leaving you feel comfortable and confident in his treatment and recommendations. 

Availability
Tuesday 8am - 6pm
Wednesday - 3pm - 7pm
Friday - 3pm - 7pm

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