Scoliosis - Medical Malpractice Lawyers

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Scoliosis - Medical Malpractice

Scoliosis is also known as curvature of the spine. In most cases, it represents a sideways curvature of the spine but conditions like dorsal kyphosis or a "dowager's hump" are also considered forms of scoliosis. These are curvatures that go from front to back instead of sideways.

Doctors recognize three causes of scoliosis. These include those that are present at the time of birth, considered "congenital". This happens when the bones aren't formed properly and are deformed when the child is born. There is also neuromuscular scoliosis. This happens when there is muscle control on one side of the body that isn't matched with equally strong muscles on the other side of the body. The muscle imbalance causes scoliosis. Paralysis can cause scoliosis as well as conditions like muscular dystrophy, spina bifida, polio and cerebral palsy. Finally, there is idiopathic scoliosis for which there is no cause. This usually occurs in normal adolescents, especially girls.

Most situations of scoliosis seem to happen in girls who are naturally prone to developing a spine curvature. This curvature generally worsens around the time a person is undergoing a growth spurt. It is less common in babies and young children and, if it occurs at this age, it tends to occur in both boys and girls.

There may be no symptoms of scoliosis and it may only be suspected by the doctor during a scoliosis screen. In such cases, the pelvis looks tilted or one shoulder rides higher than the other. When the child bends over, one side of the back rides higher than the other and it looks like they have a lump on one side when compared to the other. Other symptoms include backache, low back pain, uneven shoulders, obvious curvature of the spine and fatigue from carrying the back in an abnormal shape. The individual may seek the services of a chiropractor from chronic back pain. This is usually when the scoliosis is discovered if not discovered during a school screening exam prior to that.

The doctor or other healthcare provider diagnoses a case of scoliosis through a careful history and physical examination. The examination for the condition involves having the child bend over and touch his or her toes. The back is then examined in a test called the "forward bending test". X-rays can evaluate the exact degree of curvature or rotation in the spine and the degrees of curvature are determined. The nerves and reflexes are examined to make sure there isn't any damage to the nervous system because of the scoliosis. There is a device known as a scoliometer which can assess the degree of curvature of the spine. An MRI exam is done if there is any suggestion of neurological involvement because of the condition.

There is fortunately treatment for scoliosis and it all depends on what is causing the curvature, how old the patient is, how much more growing the patient has to do, the location of the curvature and other factors. In mild cases, less than about 20 degrees, the patient is often watched and the scoliosis gradually works itself out as the patient grows. Exams every six months or so are recommended.

In a child that is still growing with a curvature above about 25-30 degrees, bracing of the back is recommended to help straighten out the back or prevent further curving of the back. There is the Boston Brace, the Wilmington Brace, the Charleston Brace and the Milwaukee Brace-each of which is slightly different but basically do the same thing. Some braces are more comfortable than others and some are reserved for only the severest of cases of scoliosis. Exactly which brace is used depends on the patient and the comfort level of the doctor.

Some patients need surgery. This especially occurs at the time the skeleton stops growing. If the curve is bad at the time the growth plates fuse, then surgery is recommended. This is usually done in older adolescents or adults. Curvatures of at least 40 degrees often require surgery to repair.

The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here