Dr. Allan Horowitz, published newspaper article, Richmond Hill Liberal, Copyright September 28, 1988

Properly defined, the term scoliosis means a lateral deviation of the spinal column. In theory, the spinal column, or the spine as most people refer to it, is supposed to be straight. In reality, there may be minor deviations from the ideal, and usually these small deviations from normal will never be noticed in a healthy person.

Sometimes, however, the spine may develop in such a way that it is far from straight and a noticeable curve develops. This is referred to as scoliosis.

The reason a straight spine is important is very simple, if an analogy is considered. If you stack 24 blocks (there are 24 bones in the spine) on top of each other in an exact, perfectly erect formation, and then place a glass of water on top of the stack, it is likely no spillage will result.

If, however, the blocks are stacked in a haphazard way, so that one block is not resting directly on top of the one below, the column will be much less stable, and you will soon be mopping up water.

The same holds true for your spine. If the spinal column is straight it is better able to withstand the stresses placed upon it. A curved spine will likely result in back or neck pain because the spinal joints are not properly aligned, and they will likely be jammed together whenever certain movements are performed.

Even if no excessive motion is required of the spine, the muscles which support the spine will become fatigued, tight, and sore because they will be forced to work overtime to support the spine in an upright position. This leads to afternoon or evening backaches where the victim feels like the only way to relieve his pain is to get off his feet, and perhaps soak in a hot bath.

There are numerous causes of scoliosis, most of which are very rare and need not be considered here. There are also many different types of scoliosis, some also associated with rotation of the spine, some severe, some very mild, some very rigid and unmanageable, and some very definitely manageable.

The most common type of scoliosis is referred to as “idiopathic thoracic scoliosis”. This type of curve shows up in females in 80 per cent of the cases, and results in a curve in the middle back. We do not know why it occurs, but it is very important to have every young child examined and screened for scoliosis when they reach the age of seven or eight.

Because the growth spurt begins in females earlier than males, it is especially important to have these young girls examined.

If no curve is detected and no hint of anything abnormal is found, the child should be examined again one year later. If anything out of the ordinary is found, then appropriate action should be taken.

If the screening was done by a parent or nurse, the child should be referred to a doctor or chiropractor so that spinal x-rays and further testing might be done. If the curve was detected by the family doctor or chiropractor, usually monitoring any progression will be all that is required for the next couple of years.

If the curve is increasing at a rapid rate, a specialist should be consulted. These specialists are known as pediatric orthopedic surgeons, and they are the ones who will decide what, if any, more drastic action should be taken to arrest the curve.

So far, only back pain has been mentioned as a possible consequence of scoliosis. In reality, a major spinal curve could lead to serious respiratory and cardiac difficulties because the abnormally-positioned spine is interfering with the heart and interfering with the flow of oxygen to the lungs.

In serious cases like these, surgery might be the only answer. Every doctor who deals with scoliosis agrees on one point – the earlier the scoliosis is found, the better are the chances for proper management, and the less are the possibilities for chronic pain and/or disability.

In next week’s column, I will describe how to screen for scoliosis.