Scoliosis causes the spine to curve unnaturally to the side and rotate, and as a progressive 3-dimensional spinal condition, treatment needs to be proactive. There are also different types of scoliosis to consider, some more common than others; the most common type of scoliosis to affect all ages is idiopathic scoliosis with no single-known cause.
Scoliosis is a prevalent spinal condition with between 6 and 9 million people diagnosed in the United States alone; 2 to 3 percent of the population are affected. Scoliosis is the leading spinal condition among school-aged children and is often diagnosed during periods of rapid growth, but with early detection, many cases are highly treatable.
Scoliosis is most often diagnosed during adolescence, but it can also develop later in life and affects all ages.
How Many People Have Scoliosis?
Most people have heard of scoliosis and are aware it’s a spinal condition, but few are aware of its prevalence.
Not only is scoliosis the leading spinal condition to affect school-aged children, current estimates have approximately 7 million people living with scoliosis in the United States alone, and remember, these numbers only include known diagnosed cases; it’s not uncommon for people to be living with scoliosis unaware.
With an approximate 7 million people diagnosed, this translates to 2 to 3 percent of the population in the United States living with scoliosis.
Scoliosis Prevalence in Childhood
Scoliosis is most often diagnosed during adolescence. Females are diagnosed often at the onset of puberty, around 11 years of age, and it appears a little later in males.
Girls and boys are diagnosed with scoliosis at similar rates, but girls are more likely to experience progression that requires a more comprehensive treatment plan.
While estimates vary, approximately 1 to 3 percent of adolescents will develop scoliosis.
Adolescent idiopathic scoliosis is the most prevalent type of scoliosis overall, and as a progressive condition triggered by growth, adolescents are the most at risk for rapid advancement, making early detection and intervention crucial.
Babies can also be born with scoliosis as congenital scoliosis, and these cases develop due to spinal malformations that develop in utero; this form is rare, affecting approximately 1 in 10,000 babies who often present with additional congenital abnormalities so require comprehensive assessment.
Infants can also develop idiopathic scoliosis and is diagnosed between the ages of 6 months and 3 years old as infantile scoliosis and accounts for approximately 1 percent of idiopathic scoliosis pediatric cases.
Some cases of infantile idiopathic scoliosis resolve on their own, while others progress with growth, and there is no way of knowing which cases will resolve, and which will increase in severity over time.
Early-onset juvenile scoliosis is diagnosed between the ages of 3 and 10 years old and accounts for approximately 12 to 20 percent of pediatric cases.
As mentioned, adolescent idiopathic scoliosis is the most common type of scoliosis with up to 3 percent of adolescents affected.
Because scoliosis is most often diagnosed during childhood, many don’t realize it also affects adults; in fact, the actual rate of scoliosis increases among the aging population.
Scoliosis Prevalence in Adulthood
There are two main types of scoliosis to affect adults: pre-existing adolescent scoliosis in adulthood or degenerative scoliosis.
Although growth is the main trigger for scoliosis progression, adults can still progress, and among older adults, age-related degenerative changes to spinal health can trigger the onset/progression of scoliosis.
The most common type of adult scoliosis is pre-existing idiopathic scoliosis from adolescence that, in many cases, wasn’t diagnosed or treated during adolescence and has progressed with time and growth, becoming more noticeable once skeletal maturity has been reached and scoliosis becomes compressive.
Childhood scoliosis isn’t always painful, particularly while growth is occurring, and with mild curves, symptoms can be subtle and often don’t cause functional deficits. The development of an unnatural spinal curve seems highly noticeable, but that’s not always the case.
It’s a common scenario that mild cases go unnoticed until a certain amount of progression has occurred; this highlights the importance of regular screening for early detection and intervention.
When the spine is growing, it’s constantly being lengthened, and this counteracts the compressive force of the scoliosis.
If adolescents are treated while they’re still growing, their spines would be more flexible and there is more potential for correction through nonsurgical treatment; this is a primary benefit of diagnosing scoliosis and starting treatment early.
Degenerative De Novo Scoliosis
After idiopathic scoliosis, degenerative scoliosis is the most prevalent type of scoliosis to affect adults, and it develops later in life, after the age of 45, and is caused by instability in the spine caused by degenerative changes.
While children are more frequently diagnosed with scoliosis, it becomes more common in the aging population with rates as high as 35.5 percent of adults over the age of 60 developing scoliosis, and rates increasing to as high as 68 percent in patients between the ages of 60 and 90.
The increase in prevalence is due to age-related degeneration and the cumulative effect of certain lifestyle choices.
In addition to scoliosis introducing uneven pressure to the spine and its surroundings, factors such as carrying excess weight, lack of exercise, chronic poor posture, and lifting heavy objects incorrectly can, over time, also contribute to uneven pressure and wear on the spine’s discs and facet joints.
Most degenerative changes to spinal health starts with the discs that sit between adjacent vertebral bodies, and because the discs don’t have their own vascular supply, they can be slow to heal and once the degenerative cycle is initiated, it can be difficult to disrupt; early intervention can help.
Because degenerative scoliosis develops later in life with no prior history, it’s also known as de novo scoliosis, and because it’s caused by degenerative instability, most cases are progressive and painful.
Lower back pain and mobility changes are the most common symptoms of degenerative de novo scoliosis, and improving the spine’s balance and stability for fall prevention is a focus of treatment.
Conclusion
There are a number of spinal conditions that cause a loss of the spine’s healthy curves and alignment, the most common of which are lordosis, kyphosis, and scoliosis.
Lordosis causes an excessive forward spinal curve in the cervical or lumbar spinal sections, and kyphosis causes an excessive backward spinal curve in the thoracic spine.
Scoliosis causes an unnatural lateral sideways spinal curvature with rotation, and while it can develop in any of the spine’s main sections, or in more than one, it most commonly affects the thoracic spine.
It’s estimated that between 6 and 9 million people are currently living with scoliosis in the United States alone, and if the number of people living with scoliosis unaware could be added, the number would likely increase exponentially.
Adolescent idiopathic scoliosis diagnosed around the onset of puberty and into young adulthood is the most common type of scoliosis, and adolescent girls are more likely to experience rapid curve progression than boys of the same age.
Scoliosis is considered a childhood condition by many, but the actual rate of scoliosis increases among the aging population due to age-related spinal degeneration and the cumulative effects of lifestyle factors.
All types and severity levels of scoliosis require treatment; as a progressive condition triggered by rapid growth spurts, adolescents are the most at risk for rapid advancement, and how scoliosis is managed during growth is key.
When scoliosis is treated proactively, it can be highly responsive, and while a patient’s treatment outcome can never be guaranteed, the sooner scoliosi is diagnosed and treated, the better.
Here at the Atl anta Scoliosis Center, scoliosis education for awareness is a priority; patients need to be aware of the early signs of scoliosis to watch for and the pros and cons of different treatment options available to them.
Most importantly, given how common scoliosis is among children, particularly if there is a family history of scoliosis, early and regular scoliosis screening is recommended to facilitate early detection and intervention.
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