Scoliosis describes an abnormal curvature of the spine, where it bends sideways and may also rotate. Levoscoliosis is a specific type of this spinal curvature, characterized by a distinct bend to the left side of the body. This condition can affect individuals across all age groups, from infants to adults.
Defining Levoscoliosis
Levoscoliosis refers to a three-dimensional curvature of the spine that specifically bends to the left, as indicated by the prefix “levo.” Unlike typical scoliosis curves, which often bend to the right, a left-bending curve, especially in the thoracic spine, can sometimes signal a deeper underlying medical concern.
Physical characteristics of levoscoliosis include uneven shoulders or hips, a head not centered over the torso, or one arm appearing to hang lower. A noticeable curve in the back or a rib hump on the left side may also be present. Levoscoliosis can affect any part of the spine, including the cervical, thoracic, or lumbar regions, though it most commonly affects the lumbar spine.
Causes and Types
The origins of levoscoliosis vary, classifying the condition into several types. Idiopathic levoscoliosis is the most common form, meaning its precise cause remains unknown. This type often develops during adolescence, thought to involve a combination of genetic and environmental influences.
Levoscoliosis can also be congenital, present at birth due to abnormal spinal development or fused vertebrae. Neuromuscular levoscoliosis is associated with underlying conditions affecting spinal muscles and nerves, such as cerebral palsy or muscular dystrophy. Degenerative levoscoliosis can occur in adults from age-related spinal wear, including osteoarthritis or disc degeneration. Spinal injuries or tumors can also lead to levoscoliosis.
How Levoscoliosis is Diagnosed
Diagnosis of levoscoliosis typically begins with a thorough physical examination. A healthcare provider observes the patient’s posture, spinal alignment, and looks for signs like uneven shoulders, hips, or a rib prominence. The Adam’s forward bend test, where the patient bends forward, is a common screening method that makes spinal asymmetry or a rib hump more visible.
If a spinal curve is suspected, imaging techniques confirm the diagnosis and assess its severity. X-rays are the primary diagnostic tool, providing clear images of the spinal curvature. The Cobb angle, a measurement on X-rays, quantifies the curve’s degree; 10 degrees or more indicates scoliosis. MRI or CT scans may be used to further evaluate the spine’s structure if a neurological issue or congenital malformation is suspected.
Managing Levoscoliosis
Management approaches for levoscoliosis are tailored to each individual, considering age, curve severity, and progression. For mild curves (typically less than 25 degrees), observation is often recommended. This involves regular monitoring through periodic physical examinations and X-rays to ensure the curve does not worsen.
For moderate curves (generally 25-45 degrees), particularly in growing individuals, bracing may be prescribed. Braces are custom-made devices worn to prevent further curve progression, usually for many hours each day until skeletal maturity. Physical therapy, including specific exercises like the Schroth method, can be a complementary approach. These exercises aim to improve muscular symmetry, flexibility, and posture, though they do not correct the spinal curve itself.
In cases of severe or rapidly progressing curves (often exceeding 45-50 degrees), surgical intervention like spinal fusion may be considered. This procedure involves joining vertebrae together to straighten and stabilize the spine. The overall goals of management are to prevent curve progression, improve function, and alleviate any associated discomfort.