This story was originally titled "Scoliosis" in the March 2009 issue. Subscribe to Canadian Living today and never miss an issue!

Vewed from the back, your spine should look like a straight line. But people who have scoliosis have an abnormal S- or C-shaped curve to their spine. They may also have a rotated spine, caused by vertebrae that have twisted along the axis of the spine. And people with scoliosis may have a rotated trunk, or one leg may be shorter than the other. Here’s what you need to know about scoliosis, also referred to as a curvature of the spine.

Poor posture is not the cause.
In 85 per cent of cases, the exact cause of the curvature is unknown. Scoliosis can be inherited or caused by a birth defect such as spina bifida, which involves the incomplete development of the spinal cord. Other possible causes include:
• a neuromuscular disorder, such as muscular dystrophy, that weakens skeletal muscles;
• cerebral palsy, in which brain damage can affect body movement and muscle coordination;
• neurofibromatosis, a condition that causes tumours to grow on nerve tissue; and
• Marfan syndrome, a disorder that affects connective tissue.

Preteen girls and boys are at the highest risk of developing scoliosis.
The condition is most common between ages 10 and 12, just before puberty, says Dr. Reinhard Zeller, head of the orthopedic spine service at the Hospital for Sick Children in Toronto. For reasons that are still unclear, girls develop it more often than boys (about 60 to 80 per cent of cases are female), while boys represent more serious cases. In most instances, though, the cause is not known, so it’s called adolescent idiopathic scoliosis.

Younger children and babies can be afflicted (known as infantile scoliosis), as can people over age 50, although these latter cases are typically the result of disc degeneration.

Page 1 of 2Early detection is key to a positive outcome.
Since adolescence is typically defined by a period of rapid growth, during this time children with scoliosis may experience a worsening of the curvature. That's why it is so important to reverse the problem as early as possible. "The sooner it's detected, the more chance we have to correct it with a brace, and avoid surgery," says Zeller. Since scoliosis has no symptoms (unless the condition has become extreme), you need to pay attention to these physical signs:
• leaning to one side, instead of standing up straight;
• uneven shoulders, waist or hips;
• one shoulder blade appearing more prominent than the other;
• head appearing misaligned over the pelvis; and
• in females, one breast appearing more prominent, because of spine rotation.

The severity of scoliosis is measured in degrees.
Doctors look at X-rays of the spine to measure the angle of the curve. A normal, straight spine measures zero degrees. A spine that is mildly affected by scoliosis has a curve of 20 degrees or less. A curve that measures greater than 70 degrees can lead to health complications if your rib cage pushes against your heart and lungs. This may cause significant breathing difficulties, as well as an increased risk of lung infections and pneumonia.

There are several ways to prevent scoliosis from getting worse.
• Checkups: If your scoliosis is not severe (20 degrees or less), your doctor may only want to monitor your condition. In 90 per cent of cases, scoliotic curves are mild and do not require active treatment.
• Brace: If your curve is about 20 degrees, and progressing, you will likely need to wear a brace to prevent it from worsening. The brace is worn until the spine has finished growing. For girls, this is usually two years after they get their first period. In 15 to 20 per cent of cases the brace is not effective, so doctors may turn to the next treatment option.
• Surgery: This is an option for curves of greater than 50 degrees. Metal rods are used tostraighten the spine to reduce the severity of the curve.

How to home screen your child for scoliosis
Here's how to do a simple test at home to detect an abnormal spinal curve.
1. Stand behind your child and ask her to bend forward from the waist, with her head down and her hands together in front of her.
2. Examine your child's back, keeping an eye out for humps in the upper back, unevenness in the lower back, asymmetrical hips, and uneven shoulders and shoulder blades.
3. You can repeat the test by having your child turn around to face you, as you again look for any abnormalities.
4. If you do find anything unusual, see your doctor.

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