Scoliosis
Scoliosis is defined as a lateral curve or angular deviation from the normal straight position of the spine as viewed from behind. There are two types of scoliosis, the functional and the structural types.
Scoliosis is a functional type when the development of a lateral curve is basically due to a tilting of the pelvis, such as with a short lower extremity on one side or a contracture of the hip or knee. There are no structural changes in the vertebrae involved in the curvature. In this type, the management is directed towards the cause.
There are many conditions that can produce structural changes in the vertebral bodies. These could be congenital, secondary, and idiopathic.
In the congenital variety, the child may be born with one or more vertebral body defects usually associated with fused ribs. On the other hand, Poliomyelitis patients without any spinal deformity may develop a secondary type of scoliosis years after the infection. One characteristic here is that the curvature may appear and worsen even after the period of growth is completed and this may occur in the adult who acquires poliomyelitis. Another type of secondary scoliosis which will eventually disappear in time is that one produced following empyema or thoracoplasty.
The idiopathic variety of the functional type of scoliosis has remained an orthopedic problem. The cause is unclear. This is more common among females and between the ages ten and twelve years. This is commonly missed not until the parent notices the deformity during adolescence.
Early diagnosis is very crucial because the curvature can worsen up to the end of the growth period, 13 years in girls and 14 years in boys.
The characteristic deformity in this type of scoliosis shows a right dorsal curvature, a hump on the right back produced by deformity of the ribs, a flat right breast and a prominent left one and in decompensated cases, a prominent left pelvis with the left arm touching it while the right arm hangs away from the right pelvis.