Symptoms of Scoliosis

Observing the signs and symptoms of scoliosis is not always easy, and parents may not notice the problem until it becomes significantly pronounced.  A school nurse is often the first one to raise the issue, or parents may suddenly see a difference between their child and his/her sibling, or other children, when at a pool party or on the beach.  Some signs to watch out for include uneven shoulder height, the whole body leaning to one side, and uneven rib cage or rib protrusion on one side.  For a number of parents, the first sign of scoliosis is a clear disparity in the length of one trouser/pant leg indicating a hip imbalance, or scuffing on the bottom of one side of a pant-leg.  Children may also complain of growing pains, back and/or leg pain, and abnormal fatigue, especially after long walks or other exercise.

Adults can also experience scoliosis symptoms and may be less likely to consider them abnormal in light of a stressful job, other physical aches and pains, or learned habits.  Spinal nerves are not usually compromised acutely by scoliosis, so symptoms of radiculopathy, paraesthesia, pain, numbness, and weakness are not considered indicative of scoliosis itself.  The condition may, however, contribute to other spinal problems, especially in adulthood, which can cause such symptoms of nerve compression through disc degeneration, herniation, rupture, and bulging, or through joint hypertrophy or osteophyte growth.

Back surgery for scoliosis is often recommended for children if the curvature is likely to have a cosmetic effect in adulthood, has developed to more than 45-50 degrees of magnitude, is present alongside spina bifida and/or cerebral palsy, or affects physiological function such as breathing.  Severe curvature or more than 50 degrees indicates a higher probability of the deformity progressing into adulthood.  Spinal curvatures of 70-90 degrees will begin to restrict cardiopulmonary function in most patients as the space for the lungs and heart is closed down as the spine rotates the chest.  Younger patients may be offered an alternative to scoliosis surgery which involves the use of a ribcage expander to allow more comfortable breathing and cardiac function whilst facilitating the straightened growth of the spine.  The technique is fairly novel and, while it looks promising, has little in the way of  evidence of efficacy or safety in the long-term.

When diagnosis scoliosis and considering surgical treatments for a child, a physician may also order a renal sonogram and an electrocardiogram.  This is because scoliosis as a congenital condition comes from a development issue in utero and may be present alongside defects in other organs or systems that develop at the same time.  In the third to sixth week of pregnancy the heart and kidney systems are beginning to form and these tests can give an indication of possible problems that may prevent the child from undergoing surgery or need additional treatment.

Continued Reading: Anterior Surgery for Scoliosis