Types of Scoliosis, Their Causes, Diagnosis, and Treatments
There are several types of scoliosis. The different types are categorized based on what’s causing spinal curvature. Scoliosis can also be defined based on other characteristics.
Scoliosis is a condition where the spine has a sideways curvature. Typically, the spine appears straight when viewed from behind. In scoliosis, a person’s spine has a C-shaped or S-shaped curve when looked at from behind.
There are several types of scoliosis. Doctors classify scoliosis by whether it’s structural or nonstructural as well as by the location and type of curvature.
Keep reading as we take a deep dive into the different types of scoliosis.
What are the types of scoliosis?
There are many ways to classify scoliosis. One way is by cause. Another way is by where in the spine the curvature occurs.
Next, we go over the different types of scoliosis and how they’re characterized.
What are the symptoms of scoliosis?
People with scoliosis can have symptoms like:
Idiopathic scoliosis
Idiopathic scoliosis is scoliosis for which an exact cause is not known. It’s the most common type of scoliosis, making up about 80% of all scoliosis diagnoses.
Researchers believe idiopathic scoliosis has a genetic component. About 30% of adolescents with idiopathic scoliosis have a family history.
Idiopathic scoliosis can happen at any age. It’s further divided based on your age at diagnosis.
Infantile
Infantile idiopathic scoliosis happens in children 3 years old or younger. It’s a type of early onset scoliosis, which means it’s diagnosed in a person 10 years old or younger.
Researchers note that most spinal curves in infantile idiopathic scoliosis can be resolved, especially in children with mild curves and those who receive a diagnosis at 1 year old or younger.
Juvenile
Juvenile scoliosis is when scoliosis develops between 4 and 10 years old. It’s also a type of early onset scoliosis.
Compared with adolescent idiopathic scoliosis, juvenile scoliosis is less common. It also has a higher rate of curve progression and a higher likelihood of surgery.
Adolescent
Adolescent idiopathic scoliosis occurs between 11 and 18 years old. It’s the most common type of idiopathic scoliosis.
Adult
Adult idiopathic scoliosis happens in people 18 years old and older. It may be either newly occurring or a continuation of scoliosis that you had as a child.
Researchers estimate the rate of adult scoliosis ranges from 2% to 32%. It’s also more common in older adults.
Neuromuscular scoliosis
Neuromuscular scoliosis happens in people who have health conditions that impair muscle control, specifically the muscles around the spine.
When these muscles are weakened or have frequent spasms, they cannot support the spine as effectively. This can potentially cause the spine to curve.
Examples of health conditions that can lead to neuromuscular scoliosis include:
Compared with other types of scoliosis, neuromuscular scoliosis is likely to progress and cause significant spinal deformities. Progression is also often rapid.
Congenital scoliosis
Congenital scoliosis is when you have a spinal curvature that’s present from birth. It’s rare, occurring in only 1 out of every 10,000 newborns.
Several things can happen during development that can lead to a spinal curvature. Examples include one or more vertebrae not forming properly or some vertebrae not separating completely.
Children with congenital scoliosis can also have other health issues, including those associated with the kidneys, bladder, and heart.
Degenerative scoliosis
Degenerative scoliosis is a type of scoliosis that develops in adults who previously had a typical spinal curvature. It occurs due to age-related wear and tear that affects the spine, such as due to degenerative disk disease.
Research estimates degenerative scoliosis affects 32% to 68% of adults 65 years and older. It most often affects the lower back (lumbar spine) and happens along with spinal stenosis, which is a narrowing of the spinal canal.
Many people with degenerative scoliosis have lower back pain that’s associated with activity or movement. Pain is often reduced when resting. Medications and physical therapy may provide relief.
Syndromic scoliosis
Syndromic scoliosis is when scoliosis happens due to a syndromic disease. Some examples of diseases that can cause syndromic scoliosis include:
Compared with idiopathic scoliosis, syndromic scoliosis is less likely to respond to nonsurgical treatments like bracing or casting. Major complications after surgery are also more common in syndromic scoliosis than in idiopathic scoliosis.
Structural vs. nonstructural scoliosis
Scoliosis can also be classified based on whether it’s structural or nonstructural.
Structural scoliosis is when scoliosis occurs due to a curvature in the spine.
Nonstructural scoliosis happens due to causes outside of the spine. It’s also sometimes called functional scoliosis. Causes of nonstructural scoliosis include:
The changes present in nonstructural scoliosis can affect the spine. For example, legs with a different length can cause your pelvis to tilt. Because of this, your spine may curve to help maintain balance or center of gravity.
Scoliosis curvatures
Scoliosis can also be divided based on the location and the shape of the spinal curvature.
Thoracic scoliosis
In thoracic scoliosis, the curvature occurs in your thoracic spine. This is the section of your spine that runs from the base of your neck to the end of your rib cage. You can see this curvature between your shoulder blades.
It’s the most common curve location for idiopathic scoliosis.
Lumbar scoliosis
In lumbar scoliosis, the spinal curvature occurs in your lumbar spine. This is the part of your spine that makes up your lower back.
While any type of scoliosis can affect the lumbar spine, it’s the most common curve location for degenerative scoliosis.
Thoracolumbar scoliosis
In thoracolumbar scoliosis, the curvature affects the area where your thoracic and lumbar spine come together. It affects an area between your shoulder blades and lower back.
According to a 2013 research article, 40% of scoliosis curves in adolescent idiopathic scoliosis are either a thoracolumbar or lumbar curve.
Combined scoliosis
Combined scoliosis means there are two curvatures, one in the upper part of your spine and another in the lower part of your spine.
Having two spinal curvatures gives your spine an S-shape when viewed from behind, as opposed to the C-shape that’s made when a single curvature is present.
Double curves are much less common. According to 2013 research, double curves occurred only 9% of the time.
Dextroscoliosis
Dextroscoliosis is scoliosis that curves to the right. A 2014 research overview notes that curvatures to the right happen in 85% to 90% of people with adolescent idiopathic scoliosis.
Levoscoliosis
Levoscoliosis refers to scoliosis that curves to the left. While it’s less common than dextroscoliosis, levoscoliosis is more likely to be linked with other issues, such as spinal cord tumors or neuromuscular disorders.
How are the different types of scoliosis diagnosed?
Scoliosis diagnosis begins with a doctor getting your medical history. They’ll ask questions like:
A physical exam comes next. The doctor will look at your spine from all directions and check your shoulders and hips to see if they’re level.
They may ask you to bend forward 90 degrees while keeping your feet together and legs straight. This is called the Adam’s forward bend test.
X-ray imaging can confirm the presence and extent of a spinal curve.
How are the different types of scoliosis treated?
The treatment of scoliosis depends on the severity of the spinal curvature. If scoliosis is mild, a doctor may choose to monitor it periodically with X-rays to make sure it’s not worsening.
Nonsurgical treatments
If a spinal curvature is moderate or gets worse over time, a doctor will recommend casting or bracing.
Casting may still be used for infantile idiopathic scoliosis. It involves applying a cast to a child’s body that applies pressure at specific points of the spine to help correct the spinal curvature.
Bracing involves wearing a custom-fitted brace most hours of the day. It helps to keep scoliosis from getting worse. Bracing may also be used after casting.
Other nonsurgical treatments may not improve spinal curvature but may increase strength and flexibility or ease pain and discomfort. Examples include:
Surgery
Surgery is typically only used in severe situations. There are several types of surgery for scoliosis, including:
Contacting a doctor
If you think that you or your child has scoliosis, make an appointment with a doctor to discuss your concerns.
If you’ve already received a diagnosis of scoliosis, talk with your doctor if you’re concerned your spinal curvature if getting worse or if you’re experiencing significant pain or discomfort.
Frequently asked questions about the types of scoliosis
Here are answers to additional questions about types of scoliosis.
What is the most common type of scoliosis?
Idiopathic scoliosis is the most common type of scoliosis. It most often occurs between 10 years old and the end of growth. This makes adolescent idiopathic scoliosis the most common type of idiopathic scoliosis.
What is the most severe type of scoliosis?
Scoliosis curves greater than 45 degrees are considered severe. These types of curves can start to cause complications like chronic back pain, pinched nerves, and even issues with the lungs or heart.
What is the difference between C-curve and S-curve scoliosis?
In C-curve scoliosis, the spine has a single sideways curve. Because of this, the spine resembles the letter C when viewed from behind.
S-curve scoliosis has two curves, making the spine look more like the letter S when viewed from behind. S-curve scoliosis is more complex than C-curve scoliosis.
What are the different types of scoliosis?
Scoliosis is primarily categorized into four types based on its cause and the age of onset:
- Idiopathic Scoliosis: This is the most common type, making up about 80% of scoliosis cases. It has no identifiable cause and is often classified by age:
- Infantile (0-3 years)
- Juvenile (4-10 years)
- Adolescent (11-18 years)
- Adult (18+ years)
- Congenital Scoliosis: This form results from spinal abnormalities present at birth due to malformed vertebrae. It is a rare type and is generally diagnosed during infancy or early childhood.
- Neuromuscular Scoliosis: Occurs due to neurological or muscular conditions such as cerebral palsy, muscular dystrophy, or spinal cord injuries. It often leads to a long, C-shaped curve and can be severe.
- Degenerative Scoliosis: Also known as adult-onset scoliosis, it results from the degeneration of the spine components, typically affecting older adults.
What causes scoliosis?
The causes of scoliosis vary depending on the type:
- Idiopathic Scoliosis: The exact cause is unknown, though it likely involves genetic factors since it tends to run in families.
- Congenital Scoliosis: Caused by abnormal vertebral development in the womb.
- Neuromuscular Scoliosis: Due to underlying neuromuscular diseases that lead to muscle imbalance and weakness.
- Degenerative Scoliosis: Caused by the natural aging process, leading to weakening of the spine’s structure.
How is scoliosis diagnosed?
Diagnosis of scoliosis generally involves a combination of clinical evaluation and imaging tests:
- Physical Examination: Doctors look for asymmetry in the shoulders, waist, and hips. They may perform the Adam’s Forward Bend Test to check for abnormalities in the spine.
- X-rays: The definitive tool to confirm the presence of scoliosis and measure the degree of the spinal curve.
- MRI or CT scans: Used if further assessment of spinal abnormalities is needed, particularly in congenital or neuromuscular scoliosis.
What are the treatment options for scoliosis?
Treatment for scoliosis depends on the severity of the curve, the patient’s age, and other factors:
- Observation: Mild curves (less than 20 degrees) are monitored regularly with physical exams and X-rays.
- Bracing: For moderate curves (20-40 degrees) in growing children, bracing can prevent further curvature.
- Surgery: For severe curves (greater than 40 degrees) or progressive scoliosis unresponsive to other treatments. Spinal fusion is the most common surgical procedure to correct the curvature.
- Physical Therapy: Can assist in improving motion, strength, and postural habits, though it doesn’t stop or correct curvature.
- Pain Management: In adults, medications or injections may be used to manage pain associated with degenerative scoliosis.
Always consult a healthcare professional for a personalized evaluation and treatment plan.
Takeaway
There are several types of scoliosis. Severe curvatures can lead to back pain and other complications.
The treatment of scoliosis depends on the severity of the curvature and whether it’s progressing. Nonsurgical treatments can manage many cases of scoliosis. Surgery may be recommended for severe scoliosis.
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