While people are most familiar with three main types of scoliosis, there are actually four types that can develop: congenital, neuromuscular, adolescent idiopathic scoliosis, and adult de novo scoliosis. While these different types have different causes and age groups they affect, they progress relatively the same.
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Although there are still many unanswered questions regarding how and why the bulk of scoliosis cases develop, there are known causes for three of the four main types of the condition: congenital, neuromuscular, and adult denovo scoliosis. The fourth category, idiopathic, is mainly associated with children but can develop in adults as well.
While congenital, neuromuscular and some types of adult-onset denovo scoliosis have known causes, these only make up 20 percent of diagnosed scoliosis cases, and the remaining 80 percent are defined as idiopathic, meaning they have no known single cause.
Congenital, neuromuscular, and idiopathic scoliosis are mainly associated with children.
Congenital scoliosis is a spinal deformity that people are born with. In these cases, there is a bone malformation that can cause a scoliosis to develop. Although we understand how incorrect bone formations can cause a spinal deformity, experts are still unsure why people are born with the bone malformation to begin with.
If you think of a healthy spinal cord as rectangles stacked on top of each other like bricks, with congenital scoliosis, one of those bricks is shaped like a triangle and that causes the spine to tilt or curve.
Neuromuscular scoliosis develops in children with medical conditions that impair the body’s ability to control the muscles supporting the spine. Some of the most common medical conditions that cause neuromuscular scoliosis to develop include Marfan syndrome, muscular dystrophy, cerebral palsy, and spina bifida.
In most cases of neuromuscular scoliosis, the scoliosis that develops is secondary to the other medical problems the patient has.
Marfan syndrome is understood as a genetic disorder of the body’s connective tissue. It commonly affects tall and thin people with long limbs. Approximately six out of ten people with Marfan also have scoliosis. While the scoliosis that can develop with Marfan syndrome is not typically severe, a growth spurt in a child with Marfan can cause the scoliosis to progress.
Muscular dystrophy (MD) is a rare progressive disease that affects voluntary muscles that control movement of the legs, arms, and trunk. Scoliosis is a common problem for people with muscular dystrophy.
Duchenne MD accounts for 75-to-90 percent of scoliosis cases that develop as a result of the body’s muscle impairment.
Cerebral Palsy is a condition characterized by impaired muscle coordination. In many cases, cerebral palsy develops in children as a result of brain damage that occurred before or during delivery.
Children with cerebral palsy have significantly elevated chances of developing scoliosis. They are most likely to develop the condition during their early years and into adolescence. The severity of the scoliosis is closely linked to the severity of cerebral palsy and can progress beyond skeletal maturity.
Spina bifida is a congenital spinal defect where a gap in the backbone exposes part of the spinal cord and its meninges. It can cause paralysis of the lower limbs and can also affect mental function.
Approximately 50 percent of people with spina bifida will develop scoliosis. Children with spina bifida are at an elevated risk for rapid progression and large spinal curvatures. These patients are monitored closely to watch for progression during growth spurts.
When most people think of scoliosis, a 16-year-old girl comes to mind. While idiopathic scoliosis can develop in infants and juveniles, as well as adolescents, the most common age of diagnosis is between 10 and 18. This stage covers puberty and carries with it the highest risk of progression as growth spurts are a huge factor for this age group.
AIS is the most common form of the condition, affecting 4-to-5 percent of adolescents. Idiopathic adolescent scoliosis is more common in females, and while the reasons aren’t fully understood, a commonly-accepted theory is that it’s to do with postural maturity. As females tend to have larger growth spurts in shorter amounts of time, this tendency increases the likelihood of females developing idiopathic adolescent scoliosis.
Understanding multifactorial causation is an important aspect of understanding the nature of idiopathic conditions. When a condition is defined as idiopathic, the condition’s development can’t be tied down to one single specific cause. That’s not to say that an idiopathic condition can’t have multiple causes; this is referred to as multifactorial causation.
When it comes to idiopathic scoliosis, it’s generally accepted that it likely develops due to a combination of variables and that those variables can differ from patient to patient. From possible genetic predispositions, environmental factors to hormone and muscle imbalances, we just don’t know which variables result in the development of abnormal spinal curvatures.
Adult de novo scoliosis makes up the fourth type of the condition, and is most common among adult scoliosis patients.
While many cases of adult scoliosis are extensions of adolescents who weren’t diagnosed and progressed into adulthood with the condition, do novo scoliosis cases are different.
Adults with no history of scoliosis during adolescence who develop the condition fall into the ‘de novo scoliosis’ category. In the majority of these cases, spinal deformities develop because of degenerative changes to the spine that accompany aging.
Under this umbrella, there are four types of scoliosis that adults can develop: degenerative, traumatic, pathological, and idiopathic.
Degenerative scoliosis occurs in older individuals whose spinal discs are deteriorating due to the natural effects of aging, and this can lead to the development of an abnormal spinal curvature.
While experts are unsure of how severe a trauma has to be to cause the development of the condition, accidents can cause spinal deformities to develop.
Pathological scoliosis develops when tumors are present and pressing on the spine. The pressure the tumors exert on the spine can cause a curvature to develop.
While they can develop, instances of adult idiopathic scoliosis are rare. In most cases, as mentioned earlier, they are extensions of AIS cases that went undiagnosed, but of course, these cases are difficult to confirm and track.
Scoliosis is a complex condition that is still a subject of great debate in the medical community. While statistics aren’t the most important factor to consider, they do help give people a better understanding of the condition’s commonality. Following are some interesting facts and stats about scoliosis:
Scoliosis is the leading cause of spinal deformities among children and can affect infants, juveniles, and adolescents. While the condition is mainly associated with children, it can affect adults as well.
Most people are familiar with the three types of the condition associated with children - congenital, neuromuscular, and adolescent idiopathic scoliosis - while the fourth type that affects adults is often overlooked.
This tendency to focus on the three condition types is understandable; the majority of adult de novo scoliosis cases have known causes, but cases of the condition with known causes only make up 20 percent of known diagnosed cases. These numbers are significant and indicate the commonality of idiopathic cases, versus cases of adult de novo scoliosis.
Regardless of what has caused a patient’s scoliosis to develop, progression is relatively similar across the board, with growth being the big factor. Regardless of whether or not the cause of a patient’s condition is known, effective treatment is still very possible.
Here at the Scoliosis Reduction Center, we have experience dealing with every type and severity level of the condition and have seen marked improvements in 98 percent of the patients who commit to our chiropractic-centered treatment plan.