SCOLIOSIS

Scoliosis

Scoliosis is a muscular disorder in which the spine curves to the left or right when viewed from the back, creating an S or C-shaped curve. At our practice, our physicians diagnose and treat all types of scoliosis in children. While a healthy spine runs straight down the middle of the back, scoliosis causes the spinal column to deviate from this midline. The direction of the curve is important for diagnosis and are distinguished by referring scoliosis as being Levoscoliosis and Dextroscolosis. We will further discuss these types later in this document

These curves can be subtle or pronounced, and may cause visible changes in posture. By carefully evaluating the direction and severity of your child’s spinal curve, our team ensures an accurate diagnosis and tailors a treatment plan that best fits your child’s needs.

We see cases from mild to severe and offer the most advanced conservative treatment options. Most children with this condition may not need complex treatments, but they need to see a pediatric doctor who specializes in the curvature of the spine for an evaluation.

To begin with, our treatment starts with a comprehensive evaluation and diagnosis of a child. Together, we will discuss options with honesty and compassion. We partner with parents every step of the way. Thus, we can develop a personalized treatment plan for your child that makes you feel comfortable and confident in your decision.

Every case of scoliosis deserves a thorough assessment to determine the underlying cause. Factors like the age at which scoliosis begins and any other underlying medical conditions are carefully considered during our evaluation. This helps guide decisions about additional testing, ensuring we understand your child’s unique needs and can recommend the most appropriate treatments, ranging from observation or bracing to, in some cases, surgery.

The Main Types of Scoliosis are:

• Idiopathic scoliosis. 80 percent of these cases are idiopathic, making it the most common type. Idiopathic means that doctors can’t pinpoint the cause of the spinal curvature. It is further classified by the age of the patient.
• Infantile scoliosis, also known as early-onset, develops in children, mostly boys, under age 3.
• Juvenile scoliosis, more common in girls, occurs between the ages of 3 and 10.
• Adolescent scoliosis makes up the majority of idiopathic cases. It’s most common in girls between the ages of 11 and 17.
• Congenital scoliosis is present at birth and happens when the vertebrae fail to develop properly in utero. This type is rare and is often seen with other health issues related to the heart, kidney, or bladder.
• Neuromuscular scoliosis is caused by a neuromuscular condition such as spina bifida, muscular dystrophy, or cerebral palsy.

What is Dextroscoliosis?

Dextroscoliosis is a specific form of scoliosis in which the spine curves toward the right side of the body, most often affecting the thoracic (mid-back) region. This rightward curve can cause the body to appear as if it is leaning or bent to the left. The degree of curvature varies from mild to severe, so symptoms can range from subtle postural changes to noticeable shifts in body alignment.

It’s not uncommon for children with dextroscoliosis to show an uneven shoulder height or a prominent ribcage on one side. As with other forms of scoliosis, some children may not experience pain, while others might feel discomfort or muscle fatigue depending on the curve’s severity. Early evaluation is important to monitor progression and determine the most appropriate management for your child.

What is Levoscoliosis

Levoscoliosis, a type of scoliosis where the spine curves to the left, has a few unique symptoms that may show up in your child’s posture and day-to-day movement. Parents might notice the following signs:

• The spine visibly curves toward the left side when viewed from behind.
• Your child may naturally lean more to one side, almost as if compensating or side-bending to the right to help maintain balance.
• Shoulder height may be uneven, with one shoulder appearing lower than the other.
• The waistline may not look symmetrical, and the ribcage on one side can protrude more.
• One hip, typically the right, may seem higher or more pronounced.
• Muscles on each side of the spine might feel tight on one side and weak on the other due to compensatory posture over time.

These changes are subtle at first, but over time, routine posture and movement habits can reinforce these imbalances. If you notice your child’s spine drifting left of center or if their posture seems unusual in these ways, it’s important to schedule an evaluation with a pediatric orthopedic specialist.

What Causes Levoscoliosis and Dextroscoliosis?

Levoscoliosis and dextroscoliosis refer to the direction of the spinal curve, curving to the left (levo) or right (dextro), respectively. In most cases, the exact cause is unknown, making them idiopathic, which means there’s no clear reason for the curvature. Idiopathic scoliosis is by far the most common type and can occur in any age group.

However, in some instances, the curvature may be associated with underlying conditions. These causes can include:

• Genetics: There is ongoing research suggesting a hereditary component, with scoliosis sometimes running in families.
• Congenital Factors: When vertebrae don’t develop properly before birth, scoliosis can appear as early as infancy.
• Neuromuscular Disorders: Conditions such as spina bifida, muscular dystrophy, or cerebral palsy may lead to spinal curves, often in a specific direction.
• Other Medical Conditions: In rare cases, abnormalities in connective tissue or metabolic disorders can contribute to the development of scoliosis.

It’s important to know that levoscoliosis is sometimes more frequently linked with an underlying medical issue compared to typical idiopathic scoliosis. That’s why our team takes a careful, individualized approach for every child, making sure the cause is clearly understood as part of your child’s evaluation.

Potential Complications of Levoscoliosis and Dextroscoliosis

Both levoscoliosis (spine curves to the left) and dextroscoliosis (spine curves to the right) can lead to a range of complications beyond the visible changes in posture. In some cases, the abnormal curvature may begin to affect nearby nerves, leading to:

• Weakness or numbness in the legs
• Changes in your child’s walking pattern or balance

For a small number of children, especially those with more pronounced spinal curves, additional problems may develop. These may include difficulty breathing, as the rib cage and spine changes can reduce space for the lungs and impair lung function. This is more likely with severe curves or those that progress quickly during growth spurts.

Our experienced pediatric orthopedic specialists carefully monitor for these issues and work with you to address them early, using both conservative and, when needed, surgical approaches tailored to your child’s needs.

Scoliosis Symptoms

Children with scoliosis may experience lower back pain or discomfort, but most commonly, the symptoms are seen in their physical appearance. They include:

• One hip is higher than the other
• The waist looks uneven
• The rib cage is more prominent on one side
• The pelvis is tilted

How Scoliosis Can Affect Nerves, Balance, and Breathing

As scoliosis progresses, the changing curve of the spine can sometimes impact more than just posture or appearance. In certain cases, the spine may start to press against nearby nerves, which can lead to sensations of weakness or numbness in the legs. You might notice changes in your child’s walking pattern, coordination, or overall balance if scoliosis continues to advance.

In rare or particularly severe cases, significant spinal curvature can reduce the space within the chest, making it harder for the lungs to expand fully. This tightness may cause mild shortness of breath or difficulty with vigorous activity. While these complications aren’t common, early detection and a personalized treatment plan make a big difference in preventing them.

Scoliosis Diagnosis

At Medical City Children’s Orthopedics & Spine Specialists, our board-certified pediatric orthopedic physicians perform a comprehensive evaluation. Then, with the diagnosis for your child’s condition, they create a personalized treatment plan. As an example, our evaluation may include:

• A medical history
• A physical exam
• An X-ray and/or CT scan