with Andreas Klein

Unlike functional scoliosis , structural scoliosis is not a simple lateral curve of the spine . It involves a more complex three-dimensional deformity of vertebrae . Thus , the side to side curvature we see is normally a product of two abnormalities

1 . Increased lordosis ( like the bend in your lower back )

2 . Abnormal rotation of individual vertebrae with respect to one another

Structural scoliosis is actually very common . Normal children have neither straight nor symmetrical spines . Fifteen per cent of children show evidence of a lateral curvature on a visual examination and as many as 30 per cent with a more accurate measurement .

Anatomists two centuries ago clearly demonstrated that everyone had a scoliosis , albeit of small magnitude ( Dickson 1984 ). Structural scoliosis is also seven times more common in women .

It can be classified by the type of curve that is seen ( see left image ) or by the age it develops i . e . 1 . infantile 2 . juvenile 3 . adolescent By far the majority of cases are adolescent onset and screening of children allows early intervention to minimise progression .

Doctors measure the size of the curve from X-rays using the Cobb technique ( see far right ). A curvature of 20 degrees or more is considered significant , but this is rare . For example , only 2-5 people per 1000 with structural scoliosis of thoracic spine have a curve of 20 degrees or more .

Most cases of structural scoliosis ( 80 %) are of a type called ‘ idiopathic scoliosis ’. Idiopathic just means that no one knows why it occurred . For the rest there is a laundry list of conditions that lead to scoliosis , but some include :

1 . congenital ( bone abnormalities present at birth )

2 . neuromuscular conditions such as 1 . cerebral palsy 2 . muscular dystrophy 3 . connective tissue disorders 1 . Marfan ’ s syndrome 2 . rheumatoid arthritis 3 . certain dwarves

4 . trauma 1 . fractures 2 . irradiation 3 . surgery

You may need to consult an orthopaedic or neurosurgeon , and treatments in severe cases may include a Harrington metal rod , and / or bone grafts to stabilize the spine .

People with structural scoliosis are often afflicted with great back pain . They have tremendous muscle fatigue , because day-in and day-out for years , the muscles around the spine have to

stabilise the body around a bent spine . This is very hard work indeed . Fatigued muscles cells sustain damage and release chemicals of inflammation . These cause fluid accumulation and muscle swelling , and pain .

Physical therapy can help relieve pain for people with structural scoliosis , however the treatment needs to be regular and ongoing to be beneficial because the back muscles are continually over worked . If you have structural scoliosis and would like some advice , please come see us at the clinic .