Scoliosis is an very abnormal lateral curvature of the spine. It is often diagnosed in childhood or early adolescence. The spine’s normal curves occur in  the cervical, thoracic and lumbar region, in the so-called “sagittal” plane. These natural curves position is the head over the pelvis and works as shock absorber to distribute mechanical stress during movement.

Scoliosis is often called  as spinal curvature in the “coronal” (frontal) plane. While the degree of curvature is measured on the coronal plane in scoliosis is actually a more complex, three-dimensional problem  involves the 3 following planes:

  • Coronal plane
  • Sagittal plane
  • Axial plane


A coronal plane is a vertical plane in which head to foot is parallel to the shoulders, dividing the body into anterior, posterior sections.

The sagittal plane divides the body into two halves.

The axial plane is parallel to the plane which is on  the ground and at right angles to the coronal and sagittal planes.

Incidence and Prevalence

Scoliosis affects only  2-3 percent of the population, or in an  estimated value six to nine million people in the United States. Scoliosis can develop during birth  or early childhood. However, the primary age of onset of  scoliosis is 10-15 years old, occurring equally among both male and females . Females are eight times more affected in a  progress of a curve magnitude that requires treatment.


Scoliosis can be called as  etiology: idiopathic, congenital and neuromuscular. Idiopathic scoliosis is the diagnosis in which  all other causes are excluded and it comprises about 80 percent of all cases. Adolescent idiopathic scoliosis is the most common type of scoliosis who’s  is usually diagnosed during puberty.

Congenital scoliosis results from embryological malformation of one or more of the vertebrae and may occur in any other  location of the spine. The vertebral abnormalities caused curvature and other deformities of the spine because in  one area of the spinal column lengthens at a slower rate than the rest of the columns.

The geometry and location of the abnormalities determines  the rate at which the scoliosis progresses in magnitude of  the child’s growth . Because these abnormalities are present at birth, congenital scoliosis is usually detected at a very younger age than idiopathic scoliosis.

Neuromuscular scoliosis is  secondary to neurological or muscular diseases. This includes scoliosis which is associated with cerebral palsy, spinal cord trauma, muscular dystrophy, spinal muscular atrophy and spina bifida. This type of scoliosis generally progresses more rapidly than idiopathic scoliosis and they often require surgical treatment.


There are several signs which indicate the possibility of scoliosis. If one or more of the following signs is noticed, you should immediately schedule an appointment with a doctor.

  • Shoulders are uneven – first  or second  shoulder blades may stick out
  • The Head is not perfectly centered directly above the pelvis
  • One or both hips are raised out or they are  unusually high
  • Rib cages are at different heights
  • Waist is uneven
  • The appearance or texture of the skin are overlying the spinal  changes
  • The entire body leans at  one side



Scoliosis is always  confirmed through a physical examination, an x-ray, spinal radiograph, CT scan or MRI. The curve is measured by using  the Cobb Method and it  is diagnosed in terms of severity by the number of degrees. A positive diagnosis of scoliosis is made based on a coronal curvature measured by  a posterior or anterior radiograph of greater than 10 degrees. In general, a curve is considered notable if it is greater than 25 to 30 degrees. Curves exceeding 45 to 50 degrees are considered very severe and often require more aggressive treatment.




When there is a confirmed diagnosis of scoliosis, there are many issues to assess that can help determine treatment options:

Spinal maturity – is the patient’s spine still growing


Degree and extent of curvature – how much  severe is the curve and how does it affect the patient’s lifestyle?


Location of curve – according to some experts, thoracic curves are more probable to progress than curves in other regions of the spine.


Possibility of curve progression – patients who have large curves prior to their adolescent growth spurts are more likely to experience curve progression.


Minimally invasive surgery (MIS) : Fusion can sometimes be performed by using  smaller incisions through MIS. The use of  fluoroscopy and endoscopy  has increased  the accuracy of incisions and hardware placement, minimizing the  tissue trauma while enabling a MIS to approach. It is important to keep in mind that not all cases can be treated by using this and there is a number of factors that contribute to the surgical method used.


The benefits of surgery should always be weighed carefully to minimize risks. Although a large percentage of scoliosis patients will get  benefit from this surgery, there is no guarantee that surgery will stop curves from growing and symptoms in every individual.