Scoliosis is an abnormal curvature of the spine to one side. In people with the condition, the spine bends either to the left or right. The curvature in the spine can vary from being slight to severe.

The bend can occur at any point along the spine, from the top to the bottom. However, the most common regions to be affected by scoliosis are:

  • the chest area (thoracic scoliosis)
  • the lower part of the back (lumbar scoliosis)

In about 80% of scoliosis cases, the cause is unknown. This is known as idiopathic.

In the UK, scoliosis affects three to four children out of every 1,000. The condition can develop at any time during childhood and adolescence (the teenage years). Scoliosis is more common in girls than boys and often occurs at the start of adolescence.

Signs & Symptoms

Patients who have reached skeletal maturity are less likely to have a worsening case. Some severe cases of scoliosis can lead to diminishing lung capacity, putting pressure on the heart, and restricting physical activities.

The signs of scoliosis can include:

  • Uneven musculature on one side of the spine
  • A rib prominence and/or a prominent shoulder blade, caused by rotation of the ribcage in thoracic scoliosis
  • Uneven hips / leg lengths
  • Slow nerve action (in some cases)

Patients who initially present with scoliosis are examined to determine whether there is an underlying cause of the deformity. During a physical examination, the following is assessed:
  • Skin for café au lait spots, indicative of neurofibromatosis
  • The feet for cavovarus deformity
  • Abdominal reflexes
  • Muscle tone for spasticity

During the exam, the patient is asked to remove his or her shirt and bend forward. This is known as the Adams Forward Bend Test and is often performed on school students. If a prominence is noted, then scoliosis is a possibility and the patient should be sent for an X-ray to confirm the diagnosis. The number of false positive results from this popular and inexpensive school-based screening program has earned it the name schooliosis.