The spine is not an isolated bone, but it has many (called vertebrae) and joined together by a type of elastic tissue called cartilage. This gives us flexibility to bend, stretch, maintain balance and walk.
There are times when the column acquires a lateral curvature in the form of 'S' or 'C'. It is what is known by the name of scoliosis. It appears especially during childhood and adolescence and, although most of the time it is mild, measures must be taken to prevent it from evolving.
It can go unnoticed, so now that school is over it's a Good time to consult the pediatrician and start caring for the back of our children as soon as possible.
Causes that cause scoliosis
There are two types of infantile and juvenile scoliosis:
The 'secondary'. It may be due to malformations (such as congenital fusion of some vertebrae) or asymmetries in the length of the legs. It may also be associated with some diseases (such as neurofibromatosis or Marfan syndrome) or some neuromuscular diseases.
The 'primary or idiopathic'. It appears during the development of the healthy child or adolescent with no more anomaly than the spinal deviation itself. This deviation usually stops progressing at the end of bone growth, something that occurs in girls shortly after the onset of menstruation.
This is explained by Dr. Francisco Kovacs, of the Kovacs Back Unit of the Moncloa University Hospital and director of the Spanish Network of Researchers in Back Ailments (REIDE).
The expert adds that you have to go to the doctor if a child's spine begins to deviate, why determine the type of scoliosis and act in consecuense. It ensures:
“Scientific research has demonstrated facts that have radically modified the concept of idiopathic scoliosis. Fifty years ago it was considered a disease because it was believed to condition the life of the one who suffered it.
Nowadays it is known that, in the vast majority of cases, it is only a personal aesthetic characteristic, such as being blond or brown, that does not cause pain, does not carry any risk and does not worsen the quality of life present or future. "
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It accounts for 90% of cases of deviation from the spine. It is characterized in that the vertebrae are rotated, in addition to being deviated, which in the dorsal vertebrae implies that the ribs are also rotated.
That makes the deviation especially visible when the child leans forward, since the ribs seem to rise to one side and sink to the other. It usually progresses until the adolescent's growth ends.
How is ideopathic scoliosis detected?
It does not usually produce pain, so it is not easy to diagnose.
It is usually discovered at one of the pediatrician's routine controls or at school. Some signs that can warn of a possible scoliosis are that:
- The child has one shoulder higher than the other.
- One shoulder blade more prominent than the other.
- The somewhat tilted waist or a higher hip.
In these cases, it is convenient to consult the doctor who will perform two examinations to diagnose if there is:
A visual, where he inspects the appearance of asymmetries.
An x-ray, which allows you to check the total extent of the deviation of the spine. One is made in profile and the other in front.
As explained by doctors measure the curvature of scoliosis in degrees:
A curvature is slight when it does not reach 20 degrees.
A curvature is moderate when it is between 25 and 40 degrees.
A curvature is severe when it exceeds 50 degrees.
Genetic component
The reason for its appearance is not known exactly, but expert voices such as Dr. Kovacs or the Nemours Foundation speak of a genetic explanation.
It has been believed for years that the repetition of bad postures could influence the deviation caused by idiopathic scoliosis. But nevertheless, scientific studies have shown that scoliosis is essentially determined by genes that have been inherited According to the director of the Spanish Network of Researchers in Back Ailments:
"The genes most frequently linked to the onset and progression of scoliosis seem to vary from one race to another, and it is suspected that those involved in the onset of deviation and those that influence its progression are different.
The latter would be linked to the X chromosome, which would explain that, although the proportion of scoliosis (of any grade) is similar between men and women, scoliosis with higher degrees of curvature are almost ten times more frequent among girls than among boys. ".
It is known that if a parent has had it, the probability that their child has it is 30-35% higher.
"The studies carried out suggest that the influence of postures or habitual sports is minimal.""Only an 11% increase in the proportion of girls with scoliosis has been shown among those who, having been selected for having especially loose ligaments, underwent for years an intense regime of physical training, repeated for several hours daily with loads and asymmetric exercises always on the same side.
That regimen was maintained during its years of growth and bone immaturity, which were also prolonged on purpose by taking measures to delay the onset of menstruation. "
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Most cases of mild scoliosis do not need treatment and the minor should only go to regular check-ups to make sure that the curvature does not increase over time.
As it usually gets worse while the bones continue to grow, the specialist. you must be aware of how it evolves to work it and avoid it reaching a serious curvature, which can damage the lungs.
To track its progression, the curvature is measured periodically (usually once a year, or more often if the deviation grows rapidly) in 'Coob degrees', which are calculated by measurements made on a column x-ray. The calculation method has an intrinsic error of approximately four degrees.
That is, the same doctor, calculating at different times the 'Coob degrees' that the same radiograph shows, can obtain a measurement with up to four degrees of difference. Therefore, smaller variations may not reflect true changes in the curve.
This is explained by Dr. Kovacs, who does not think it necessary to subject children to frequent radiation, and to opt for other tests even though they are not yet widespread, such as photogrammetry (study and measurements on photos).
Add the expert who Continuous physical exercise is recommended for children with idiopathic scoliosis as well as for the rest., as it is shown to reduce the risk of episodes of back pain and, above all, shorten its duration.
In Babies and more Backpacks too heavy: keys to protect children's backs"It has been shown that aerobic exercise significantly improves power and anaerobic lintel among girls with scoliosis. And also that systematic exercise does not cause scoliosis, nor aggravates the degree of curvature of those who already have it."
Severe scoliosis
If your doctor thinks your spinal curvature may get worse, he may recommend a orthopedic corset for the back until the child stops growing. It does not work to correct a curvature that already exists in the spine, but it can prevent that curvature from getting worse.
The teenager with a severe scoliosis may need surgery. As explained by the Nemours Foundation, the surgery is called 'spinal fusion' or 'vertebral fusion', and serves to straighten the spine as much as possible and keep it in place with metal rods and screws.
Then the surgeon places a bone graft to join (or fuse) several vertebrae together, so that the curvature does not worsen. At one year, the vertebrae should be completely joined.
But Dr. Kovacs says that, in view of the investigations, the only parameter that idiopathic scoliosis surgery has shown to improve is the aesthetic.
The only aspect in which specialized surgeons agree is that aesthetic considerations should not be those that determine the decision to operate. Hence, as explained by the expert, the number of operations in the United States has been reduced progressively.
"Scoliosis surgery is aggressive and, although it is generally safe, it is not without risks."Even so, in all cases of scoliosis, Young people lead active and full lives after finishing treatment.
Photos | iStock
