Scoliosis - Poor Awareness And Social Stigma Leads To Delayed Diagnosis in India

Awareness is the key to catch it early and reduce the risks associated.

• Scoliosis is an abnormal sideways curve in the spine. Normally the spine has a straight alignment when seen from the front or back. A sideways curve in the spine can develop due to a various reasons at different stages of growth. As the spine grows taller, there is a tendency for the curves to worsen and can become severe by the time the kid reaches skeletal maturity.
• The curve in the spine is associated with rotation of the spinal column to one side. As the ribs attached to the spine rotate along with it, it leads to a rib hump in the back on one side and prominence of chest wall in the front on the other side. A curve in the lower spine leads to asymmetry in the waist lines. It is usually the rib hump or asymmetrical waist line that brings the problem to notice, usually at a time when the kid is growing rapidly.
• Severe curves distort the chest cavity and reduce the space available for the lungs, thereby reducing the breathing capacity, especially if the scoliosis starts before 5 years of age (early onset scoliosis). This is known to significantly reduce life expectancy due to failure of lung and heart function over the years. In some with severe curves, the spinal cord function may get affected leading to progressive weakness in lower limbs and eventually loss of ability to walk. But the most common and important complaint with scoliosis is the cosmetic appearance and related problems. The social stigma and misconceptions associated with these deformities  is often the reason for the parents not seeking medical opinion earlier. The child may suffer low confidence due to self perceived defective body image, affecting their performance in studies and sports.
• Common cause of scoliosis in infants and toddlers is a bony defect in the spine resulting in asymmetrical growth in both sides of the spine leading to a rapidly worsening curve (known as Congenital scoliosis). A bony defect during development of skeleton in the womb or during growth after birth is usually associated with birth defects in other systems like heart, kidneys and other bones and can be detected at or soon after birth. In some, it is a nerve or muscle disorder leading to muscle imbalance resulting in a curve in the spine (known as Neuromuscular scoliosis, for example: Poliomyelitis, cerebral palsy). But majority of scoliosis that is noticed in second decade of life has no known cause and is called Idiopathic scoliosis.
• Treatment options include serial observations, spinal braces, and surgical correction of the deformity depending on various factors in each individual patient.
• But the most important factor that may help reduce the severity of the problem is early detection and treatment. The risks involved in surgical correction of a severe curve are much more than in a smaller curve detected much earlier. Newer techniques like growing rods can be used in those with early onset scoliosis to prevent compromise of lung and heart function while allowing the spine to grow in a better alignment. Consult a Spine specialist if you notice any suspicious curve / asymmetry in the back in your kid.