Scoliosis: causes and risk factors – 2022


Scoliosis: causes and risk factors

Almost nine out of ten scoliosis are idiopathic, which means that specific triggers are unknown.

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Crooked posture, crooked back: In the case of scoliosis (from Greek “skolios”: crooked), the spine is permanently bent to the side, and the vertebrae are also twisted. Scoliosis already occurs in small children, with increasing age – especially in the adolescent growth phase and beyond the age of 60 – their frequency increases sharply. It is estimated that a good two percent of the population suffer from a curvature of the spine with pathological significance.

Severe forms of scoliosis are found much more frequently in girls and women. Lighter cases can often be treated excellently with consistent physiotherapy and a special corset, while severe forms usually require surgery to avoid subsequent problems as far as possible.

Scoliosis: causes and risk factors

Viewed from the side, the spine is curved in a double S-shape; viewed from the front and back, it normally forms a straight line. In some people, however, the spine bends sideways: the entire spine is twisted lengthwise. The twisting creates tensile and compressive forces, so that even the individual vertebrae and the intervertebral discs assume a distorted structure.

Almost nine out of ten scoliosis are idiopathic, which means that specific triggers are unknown. One-sided carrying or a lanky posture, for example, are not to blame for the disease, so according to studies it cannot be prevented. The tendency to scoliosis is apparently inherited because the disease tends to run in families. There is evidence that scoliosis tends to affect taller people.

About one in ten scoliosis has a known cause (“symptomatic” or “secondary scoliosis”), such as:

  • congenital malformations of vertebral bodies
  • Muscle diseases (e.g. hereditary muscle weakness diseases)
  • rheumatic diseases
  • Nerve damage that prevents the stabilizing muscles of the abdomen and back from working properly (such as myasthenia gravis, spinal cord disorders)
  • osteoporosis
  • Trauma (fracture of vertebral bones, spinal cord injuries)

Signs of scoliosis

A scoliosis of just a few degrees usually does not cause any problems and is hardly noticeable in everyday life, especially when you are clothed. You have to take a closer look. In children and adolescents, for example, the gait pattern can change in connection with scoliosis, the waist buckles, and the shoulders are typically at different heights. Especially in older people affected, scoliosis is also noticeable through back pain and tension.

With severe curvature and tension in the upper back, the lungs lose space, which can lead to shortness of breath or a feeling of pressure in the chest. Heart palpitations and digestive problems are also possible. With the passage of time and increasing severity, wear and tear and stiffening occur, the mobility of the spine decreases, and pain increases.

The course of scoliosis is difficult to predict

While infant scoliosis usually resolves on its own within the first two years of life, later scoliosis often gets worse if left untreated. This is why early detection and treatment is so important. The Cobb angle is decisive for the prognosis of an idiopathic scoliosis: the larger, the less favorable are the development prospects.

In young people, the possible residual growth (maturity of the skeleton, so-called Risser stage) is an important prognostic factor, because scoliosis often intensifies quickly, especially during a growth spurt. Within a few months, adolescents can add several Cobb degrees. An important indicator for girls is the time of their first menstrual period, which is typically the start of spurting bone growth.


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