Scoliosis is a condition characterized by a sideways curvature of the spine, often appearing as an “S” or “C” shape. This spinal deviation can range from mild to severe. Understanding its progression and stabilization factors is important.
Factors Influencing Progression
The likelihood of a scoliosis curve worsening is influenced by several factors. The initial curve magnitude is a significant predictor; larger curves at diagnosis are more prone to progression. The curve’s location also plays a role, with thoracic (mid-back) curves showing a greater tendency to advance.
The underlying type of scoliosis influences its progression. Adolescent idiopathic scoliosis, appearing during puberty without a known cause, behaves differently than congenital scoliosis, present at birth due to spinal malformations. The amount of remaining growth potential in an individual’s skeleton is a primary determinant of whether a curve will continue to worsen.
Skeletal Maturity and Progression Halting
Idiopathic scoliosis progression predominantly occurs during rapid growth, particularly adolescence. This is because the developing spine elongates, allowing curvature to increase. Once an individual reaches skeletal maturity, bones have completed their growth, and growth plates have fused.
Skeletal maturity signifies when bone elongation ceases, removing the primary mechanism for curve progression in idiopathic scoliosis. Doctors assess skeletal maturity by observing the fusion of growth plates, such as in the pelvis. While chronological age varies, skeletal maturity occurs in the late teens for girls (around 14-16 years) and slightly later for boys (generally 16-18 years).
Progression in Adulthood
While scoliosis progression often halts once skeletal maturity is achieved, it can continue slowly into adulthood. This is observed in individuals with larger curves, exceeding 40 or 50 degrees, which may increase by 0.5 to 1 degree per year. Adult progression can also be influenced by degenerative changes in the spine, such as disc degeneration or arthritis, leading to further curvature or new curves.
De novo adult scoliosis can also emerge in adulthood, linked to age-related degenerative changes. This type of curvature develops as spinal discs and joints wear down, altering alignment. Progression in adulthood, whether from existing curves or new onset, is much slower than the rapid changes seen during adolescent growth spurts.
Ongoing Monitoring and Management
Even after scoliosis progression has ceased with skeletal maturity, ongoing monitoring with a healthcare provider is recommended. This involves periodic check-ups to assess curve stability and overall spinal health, identifying any subtle changes or new symptoms. Imaging techniques may be used periodically to confirm curve stability.
When a curve is significant or causes symptoms, intervention might be considered, even after skeletal maturity. Managing scoliosis is personalized, considering the individual’s curve magnitude, associated symptoms, and overall health. Continued observation allows for informed decisions regarding long-term spinal well-being.