Index of Scoliosis Information

Pathophysiology of Scoliosis

Pathology, broadly speaking, is the "study of the nature and cause of disease or the results of disease in the body. Pathophysiology looks at the detailed malfunctioning that comes from or, alternately, causes disease.

The basic Pathophysiology of Scoliosis

Scoliosis is an abnormal sideways curvature of the spine that is typically found in children and adolescents. In most cases, scoliosis is painless. However, it can become gradually more severe if left untreated, resulting in chronic back pain. In young children, severe cases can cause deformities, impair development and be life-threatening.

In most cases, scoliosis is painless and develops gradually. It often worsens during growth spurts in children and teens. Scoliosis patients who wear a back brace over an extended period of time can usually prevent further curvature of the spine.

The cause of most cases of scoliosis cases is unknown (idiopathic). Suspected causes of scoliosis include connective tissue disorders, muscle disorders, hormonal imbalance and abnormality of the nervous system. Spinal cord and brainstem abnormalities may also contribute toscoliosis. The condition can also be hereditary.

Physicians classify the causes of scoliosis curves into one of two categories:

• Nonstructural scoliosis. Also known as functional scoliosis, this involves a spine that is structurally normal yet appears curved. This is a temporary curve that changes, and is caused by an underlying condition such as difference in leg length, muscle spasms or inflammatory conditions such as appendicitis. Physicians usually treat this type ofscoliosis by addressing the underlying condition. The term nonstructural scoliosis has also been used to describe cases involving a side–to–side curvature.
  
   
• Structural scoliosis. This is a fixed curve that is treated individually according to its cause. Some cases of structural scoliosis are the result of disease, such as the inherited connective tissue disorder known as Marfan’s syndrome. In other cases, the curve occurs on its own. Other causes include neuromuscular diseases (such as cerebral palsy, poliomyelitis or muscular dystrophy), birth defects, injury, infection, tumors, metabolic diseases, rheumatic diseases or unknown factors. The term structuralscoliosis has also been used to describe cases involving a twisting of the spine in three dimensions rather than a sideways curvature.

Certain factors are known to increase the risk for scoliosis, as well as the risk that the disorder will become more severe. These include:

• Sex. Girls ages 3 and older are more likely to have scoliosis than boys. In contrast, boys are more likely to have the disorder than girls before age 3.
   
• Age. The younger a child is when scoliosis begins, the more severe the condition is likely to become.
   
• Angle of the curve. The greater that angle of curve, the increased likelihood that the condition will get worse.
   
• Location. Curves in the middle to lower spine are less likely to worsen than those of the upper spine.
   
• Spinal problems at birth. Children who are born with scoliosis (congential scoliosis) may experience rapid worsening of the curve.