What is the cause of scoliosis?

In 80 to 90 percent of scoliosis, the cause is unknown. In this case, it is called idiopathic scoliosis. Idiopathic scoliosis is subdivided according to lung maturity and the age of the patient.

What is the cause of scoliosis?

Scoliosis can have different causes:

Idiopathic scoliosis

In 80 to 90 percent of scoliosis, the cause is unknown. In this case, it is called idiopathic scoliosis. Idiopathic scoliosis is subdivided according to lung maturity and the age of the patient. Girls are affected three and a half times as often as boys. It is referred to as infantile scoliosis in patients up to three years of age. Scoliosis is defined as juvenile from the age of three to ten and as adolescent from the age of eleven.

Depending on the severity of the scoliosis (Cobb angle), a further increase in the curvature can be expected even after the end of the growth in length.

Congenital scoliosis

This form of scoliosis is caused by congenital developmental defects in the vertebral bodies. The frequency (prevalence) of congenital scoliosis is 0.5 to 1 percent. The classification takes place depending on the deformation of the vertebral body (formation and segmentation disorders).

Corset therapy is not effective in this case. The type and time of the operation depend on the type of malformation.

Neuromuscular scoliosis

They represent a complex and individual appearance. Neuromuscular scoliosis is to be understood as a symptom of an underlying disease. The most common causes include Duchenne muscular dystrophy, VACTERL disorders, infantile cerebral palsy and neurofibromatosis.

Early surgical correction is important, among other things, to prevent further progression of the disease and to maintain the ability to stand, walk and sit.

The extent of disease progression depends on the time of scoliosis onset, the angle between the ribs and the apical vertebra (RVAD), and skeletal maturity.

What risk factors are there?

The causes of scoliosis are still being researched. A known risk factor for the development of scoliosis is a family predisposition. According to the current state of science, RNA coding could be decisive.

Scoliosis has nothing to do with poor posture. In addition, there are no known ways to prevent scoliosis.

How is scoliosis classified?

Scoliosis is classified according to the underlying disease. The most common classification is according to Lenke. Six types of scoliosis are distinguished according to the type of curvature, the extent of the deviation in the lumbar area (lumbar) and the thoracic (affecting the chest) kyphosis and mobility. The sagittal curvature (running from front to back) is also taken into account.

The therapy depends on the extent of the diagnosed curvature (Cobb angle). It may include regular check-ups, physical therapy, corset/bodice treatments, or surgery.

What symptoms can occur?

Depending on the degree of curvature, different symptoms are caused. The focus is on the cosmetic impairment of the patients. Limitations of heart and lung function can only occur in severe scoliosis. In the course of life, untreated scoliosis can lead to restricted movement, chronic pain and increased mortality (mortality).

The following signs can indicate scoliosis:

• Difference in level of the shoulders, shoulder blades, hips or chest (“crooked” shoulders),
• Prominence of a shoulder blade,
• Waist asymmetry: skin fold on one side of the waist,
• Pelvic obliquity (tilted pelvis),
• Different waist triangles (lumbar bulge),
• Asymmetric chest,
• Rib hump,
• Skin changes over the spinous processes and
• Deviation of the spinous processes.

How does scoliosis progress?

In juvenile (childhood) idiopathic scoliosis, the Cobb angle increases by one to three degrees in 95 percent of cases by the age of ten. During pubertal growth, the Cobb angle increases by five to ten degrees per year.

In adolescent (juvenile) idiopathic scoliosis, the disease progresses more rapidly the larger the Cobb angle. Bone maturity and potential growth – skeletal maturity – also play a role. It is determined by means of a pelvic overview X-ray and given in so-called Risser stages. A Risser Stage of 0 means that bone growth is still in progress, a Risser Stage of 5 means that it is fully completed. As skeletal maturity progresses, the likelihood of scoliosis increasing decreases.

In adulthood, with a Cobb angle between 30 and 50 degrees, scoliosis increases by approximately 20 degrees over a period of 30 to 40 years. If the Cobb angle is greater than 50 degrees, a progression of 0.5 to 1 degree per year can be expected. If the Cobb angle is small or large (less than 30 degrees and more than 80 degrees), no progression of the scoliosis is to be expected.

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