For a spinal deformity to be considered scoliosis, there has to be both a bend in the spine that measures more than 10 degrees, plus associated rotation. If you have one without the other, it’s not considered scoliosis.
To fully understand the significance of scoliosis, we’ll discuss the difference between a postural issue and a scoliotic curve. We’ll also look at some basic spinal anatomy to better understand the importance of healthy curves and what ‘kyphosis’ refers to.
If you were to look at a healthy spine from the side, you would see that its curves make a soft ‘S’ shape. When there is a loss of those healthy curves, the body responds by putting in bad curves.
Have you ever wondered why the spine is curved in the first place? A healthy spine has three natural curves: cervical curve, thoracic curve, and lumbar curve.
The cervical curve (upper back) is an inward curve at the neck; the thoracic curve (middle back) is an outward curve of the upper back; the lumbar curve (lower back) is an inward curve of the lower back.
The spine is curved because it makes it stronger, better able to evenly distribute force, and allows for more flexible movement.
When scoliosis is a factor, those healthy curves are lost. The term ‘kyphosis’ refers to the normal outward curve of the spine, mainly in the thoracic region, and ‘lordosis’ refers to the spine’s healthy inward curves of the cervical and lumbar regions.
Kyphosis and Lordosis are terms that refer to the spine’s healthy curves, but these terms are also used interchangeably to refer to conditions where those healthy curves are lost; therefore, lordosis also refers to a spinal curvature disorder characterized by a significant inward curve to the lower back, and kyphosis refers to a spinal curvature disorder characterized by a significantly rounded upper back.
In order for a spinal deformity to be diagnosed as scoliosis, two characteristics have to be present: a spinal curvature of 10+ degrees and rotation.
Size of the Curvature
To be diagnosed as scoliosis, the patient must have a sideways bend in their spine that measures more than 10 degrees. This measurement is known as the ‘Cobb angle’ and is taken via X-ray. The Cobb angle refers to the most tilted vertebrae in the apex of the curve and how much that curve deviates from the straight alignment of a healthy spine.
When a spine curves unnaturally to the side, in a typical case of scoliosis, the curve will go to the right, not the left, because the left side of the body houses the heart. If we see a sideways curvature that bends to the left, we approach diagnosing that patient differently as there’s likely an underlying pathology at work, such as a neurological disease, congenital defect, or tumors.
The size of the curve is important, but unless it coincides with rotation, it’s not considered scoliosis.
The second characteristic needed, in order to be defined as scoliosis, is rotation. It’s not enough for the curve to bend to the side at more than 10 degrees; that bend has to coincide with rotation, which is why scoliosis is described as a 3-dimensional condition.
If a patient has a curvature of 10+ degrees with rotation, this is a true scoliosis. Having these two characteristics of the condition means there is a structural deformity at work and rules out the possibility that it’s merely a postural problem.
Regardless of what caused that deformity to initially develop, if it’s scoliosis, the deformity becomes structural.
Even with smaller curves of 10 degrees, I’ll often do a bending X-ray to see if the curve stays in the spine while bending forward. If the patient doesn’t lose the curvature, or if there’s an asymmetrical bending in the area of the scoliosis, I know it’s more than just how they’re standing or bad posture; it’s a structural deformity of the spine that’s lead to the development of the curve.
Once a patient is given an official scoliosis diagnosis, the next big step is to decide on a treatment approach. This is why it’s important to understand what fully constitutes scoliosis because, believe it or not, I have seen patients who have been misdiagnosed with scoliosis.
When it comes to treating scoliosis, any effective treatment approach has to address the structural aspect of the deformity to achieve a structural change. This is why just doing exercises alone won’t change the curve because just strengthening the back and increasing flexibility is good, but it doesn’t actually change the structure of the spine.
Regardless of where along the spine a person’s scoliosis develops, the spine isn’t just affected at the site of the scoliosis; it throws off the entire biomechanics of the spine. If left untreated, the curve is almost certain to progress.
Rates of progression vary but generally follow this pattern: adolescents progress rapidly because growth is a trigger, and adults tend to progress slower because they have already reached skeletal maturity.
As a progressive and incurable condition, you can see how treatment approach is paramount as it will shape your experience of living with scoliosis. Here at the Scoliosis Reduction Center, we can help you reach a diagnosis and treat your condition effectively. Effectively treating scoliosis means addressing the condition’s underlying cause: the structural deformity.
A patient’s condition is classified by their age, curvature type, location of curve, and severity of curve. Once we have that information, all of which becomes available with a scoliosis X-ray, we fully customize a treatment plan that addresses every aspect of the patient’s condition and overall health.
Here at the Center, we have specialists from a variety of disciplines so our patients can benefit from multiple forms of treatment at one accessible location.
I’ve never treated two patients in exactly the same way. Most often, my treatment plans combine scoliosis-specific chiropractic adjustments, exercises, therapy, rehabilitation, and corrective bracing, if necessary.
We use these disciplines to manipulate the spine to move in the direction we want it to, restoring as much of the spine’s healthy curves as possible and improving the spine’s overall biomechanics.
If a person is concerned they have scoliosis, they should know it’s more than just having a crooked spine. A crooked spine can develop from bad posture, but if that bend in the spine doesn’t coincide with rotation, it’s not considered a true scoliosis.
With a true spinal deformity that becomes a structural issue, such as scoliosis, it doesn’t matter how you stand, bend, or move; that curve will always be there. Not only will a true scoliotic curve remain regardless of position, it’s also very likely to get worse.
Whether progression is slow or fast, the only way to stop scoliosis from getting worse and improve the structural deformity is to effectively treat it by stabilizing and reducing the curvature.