There are different types of scoliosis, determined by causation. In the majority of scoliosis cases, the cause is unknown, and the remaining scoliosis types are associated with known causes: neuromuscular conditions, degenerative instability, and congenital defects.
Scoliosis is highly prevalent, particularly among children. Despite extensive studies exploring the genetic nature of idiopathic scoliosis, a single gene, or genetic mutation, accounting for its onset has yet to be identified. However, a family history is considered a risk factor, suggesting idiopathic scoliosis is multifactorial and familial.
Scoliosis is progressive, but it can be highly treatable, and regardless of the cause, all scoliosis types can benefit from assessment and treatment.
Idiopathic Scoliosis
Being diagnosed with scoliosis means an unnatural sideways-bending spinal curvature has developed, and in order to be considered a true scoliosis, the unnatural curve has a rotational component.
Scoliosis is a complex 3-dimensional spinal condition that’s progressive, so without treatment, it’s likely to get worse over time, but when it comes to potential treatment efficacy, there are a number of benefits associated with early diagnosis and intervention.
Part of diagnosing scoliosis involves comprehensive assessment so treatment plans can be customized accordingly, and underlying cause is a key factor that treatment plans are shaped around.
When it comes to exploring the genetic factors of scoliosis, we’re talking about the most common type: idiopathic scoliosis.
Idiopathic scoliosis is most commonly diagnosed during adolescence as adolescent idiopathic scoliosis.
Idiopathic scoliosis has no known cause and accounts for approximately 80 percent of diagnosed cases, and the remaining 20 percent consists of less-common types associated with known causes: neuromuscular scoliosis, degenerative scoliosis, and congenital scoliosis.
So we know that scoliosis can be caused by the presence of a neurological or muscular condition such as cerebral palsy, spina bifida, muscular dystrophy, or spinal muscular atrophy (neuromuscular scoliosis), and we also know that age-related degenerative changes in the spine can cause increasing instability (degenerative scoliosis). We also know that scoliosis can be present at birth due to spinal malformations that develop in utero (congenital scoliosis).
But what about idiopathic scoliosis? Is there a genetic component? Is having a family history of scoliosis considered a risk factor?
Is Scoliosis Genetic?
It is widely accepted that although scoliosis isn’t considered a genetic and inheritable condition, there are some genetic factors involved in its onset.
Idiopathic scoliosis is the most prevalent type of scoliosis to affect all ages, is the leading spinal condition among school-aged children, and as a progressive condition triggered by growth, how it’s managed during periods of rapid growth can have far-reaching effects.
For a condition or disease to be labelled genetic and heritable, a single gene, or genetic mutation, has been identified that accounts for its development, but despite extensive studies launched in search of a specific scoliosis gene, one has yet to be found; instead, it’s been suggested that scoliosis may be polygenetic.
Polygenetic conditions are thought to be caused by several genes interacting with environmental factors. It’s been suggested that several genes may combine to contribute to the onset of idiopathic scoliosis, and multiple additional factors shape and contribute to its progression.
Idiopathic scoliosis is considered to be multifactorial: caused by a number of factors, or a certain combination of factors, that may vary from person to person.
Scoliosis Risk Factors
While there are no treatment guarantees, with progressive conditions like scoliosis, the timing of treatment can be crucial, particularly during periods of rapid growth in children.
The treatment benefits associated with early detection and treatment are crucial, which is why, in the past, schools across the United States conducted periodic scoliosis screenings to identify scoliosis early, but concerns over cost and efficacy have shifted the onus of early detection onto parents, caregivers, and patients themselves.
Knowing there are risk factors in place, and understanding their significance can lead to early detection, intervention, and increases the likelihood of a successful treatment outcome.
There are a number of scoliosis risk factors to be aware of including patient age, gender, and family history.
Scoliosis is most often diagnosed during adolescence; in females, it’s commonly diagnosed at the onset of puberty, around 11 or 12 years of age, and it’s diagnosed a little later in males.
Scoliosis tends to develop earlier in females and is also significantly more likely to progress, so females approaching puberty can benefit from screening, and if there is a family history of scoliosis, early and regular screening is recommended to start before puberty.
There are a number of benefits to diagnosing scoliosis and starting treatment prior to the first significant pubescent growth spurt.
Family History
So if scoliosis isn’t fully genetic, why does a family history increase the likelihood of future diagnoses within a family?
Keep in mind the suggested multifactorial nature of idiopathic scoliosis and the many common factors that families share; it’s a lot more than genes alone.
Families can share body type, diet, lifestyle, mental health, posture, geographical and socioeconomic factors, and more, so it’s difficult to determine whether or not multiple diagnoses within a family is due to genetics alone.
So facts you should know: idiopathic scoliosis onset can involve a number of genetic, familial, environmental, and developmental factors. Because a specific scoliosis gene hasn’t been identified, it’s more accurate to describe scoliosis as multifactorial and familial than genetic.
If there is a family history in place, children should be regularly screened, particularly as puberty approaches because adolescents are the most at risk for rapid progression.
It’s important to understand, however, that although a family history of scoliosis does increase the risk, most cases develop without a family history, and a patient’s rate of progression is more associated with environmental and developmental factors.
Progression
The nature of scoliosis is to progress over time, and as the size and rotation of the spine’s unnatural curve increases, symptoms become more severe and noticeable, and the condition is becoming more difficult to correct.
Scoliosis ranges in severity from mild scoliosis to moderate scoliosis, severe and very severe cases, and treatment started early in a condition’s progressive line means when the curve is smaller, more flexible, and more responsive to treatment.
Curve progression increases spinal rigidity and instability, and the longer scoliosis effects are in place, the more difficult they may be to improve and/or reverse.
In children, the earliest signs of scoliosis are postural changes such as uneven shoulders and hips, but particularly when mild, these early indicators can be subtle and difficult to notice; this is why awareness is so important.
If risk factors are in place, it’s even more important for parents and caregivers to watch out for signs of asymmetrical and abnormal posture, and as scoliosis progresses, disruptions to balance, coordination, and gait can also occur.
While a single postural asymmetry doesn’t guarantee a diagnosis of scoliosis, particularly if there are risk factors in place, it does warrant assessment by a professional, and if additional indicators are detected, further testing in the form of an X-ray is the next step in the diagnostic process.
Conclusion
There are many facts you should know about scoliosis, but perhaps the most important, in the context of idiopathic childhood scoliosis, is that early detection, and the timing of treatment, is crucial.
Scoliosis progresses as a child grows, and the rapid and unpredictable growth spurts of puberty can trigger rapid curve progression and advancement of the condition’s effects.
Increasing postural changes can further disrupt healthy movement patterns and contribute to uneven wear and tear on the spine and its surroundings; the effects of a misaligned spine can be felt throughout the body.
While there are genetic factors that appear to play a role in the etiology of scoliosis, we still don’t fully understand what triggers the initial onset of idiopathic scoliosis, and it’s generally considered to be more familial and multifactorial than genetic.
Regardless of what initially triggers scoliosis to develop, what becomes more important is how a diagnosis is responded to with treatment, and the timing of diagnosis and intervention are key factors in treatment efficacy.
From a patient’s initial comprehensive assessment to the crafting of a fully-customized treatment plan, the Scoliosis Reduction Center® values a proactive multimodal treatment approach with potential to restore the spine and body’s healthy alignment.
