Scoliosis Detection and Treatment
What Is Scoliosis?Scoliosis is a three-dimensional condition of the spine that affects about 3% of the population. Viewed from the back, scoliosis can cause the spine to look like a C or S shape instead of a straight vertical line. Viewed from above, scoliosis can also cause a rotation of the spine, like a corkscrew. Imaging is required for a confirmed diagnosis, with curves measuring at least 10 degrees in the coronal plane considered a medical diagnosis of scoliosis.
What Is The Forward Bend Test?
The Forward Bend Test, or Adams Forward Bend test, is a visual analysis of the spine and trunk while the patient is leaning forward at the waist, with legs straight, back horizontal, and arms hanging freely with palms facing. The Adams Forward Bend Test increases tension on the spine and may make it easier to notice curves in the spine, rib humps, or trunk asymmetries (where one side is higher than the other). You can ask your child's doctor about the Adams Forward Bend Test at your next visit. Imaging is always required to confirm a diagnosis of scoliosis.
What Are Other Signs Of Scoliosis?
As scoliosis progresses other signs may become visible, including uneven shoulders, prominent shoulder blade, uneven waistline, and uneven hips while standing.
Why Is No-Dose or Low-Dose Imaging Often Recommended For Children With Scoliosis?
Children with scoliosis may require frequent imaging to monitor progress and brace correction, and studies have shown that increased radiation for scoliosis patients from repeat imaging can increase the risk of developing cancer later in life (2). A number of scoliosis clinics and specialists now offer stand-up (weight bearing) no-dose MRI or low-dose EOS imaging for this reason.
How Is Scoliosis Treated?
Smaller curves are typically treated with bracing (3), especially during growth and often along with scoliosis-specific exercises, while larger curves may require surgery. Be sure to seek the medical advice of a scoliosis specialist with a track record of success. Getting a second or even a third medical opinion is often advised, especially in complex cases.
(1) Cobb JR (1948) Outline for the study of scoliosis. Am Acad Orthop Surg Instr Course Lect 5:261–275
(2) Simony A, Hansen EJ, Christensen SB, Carreon LY, Andersen MO. Incidence of cancer in adolescent idiopathic scoliosis patients treated 25 years previously. Eur Spine J. 2016 Oct;25(10):3366-3370. doi: 10.1007/s00586-016-4747-2. Epub 2016 Sep 3. PMID: 27592106. (3) Weinstein, Stuart L.; Dolan, Lori A.; Wright, James G.; and Dobbs, Matthew B., "Effects of bracing in adolescents with idiopathic scoliosis." The New England Journal of Medicine. 369, 16. 1512-1521. (2013).