Scoliosis describes an abnormal sideways curvature of the spine, where it bends to the left or right. While the spine naturally possesses slight inward and outward curves, scoliosis introduces an atypical side-to-side bend. This article will focus on sigmoid scoliosis, a specific type of spinal curvature.
Understanding Sigmoid Scoliosis
Sigmoid scoliosis is characterized by two unnatural spinal curves that bend in opposite directions, forming an “S” shape within the spine. This differs from other forms of scoliosis that might involve a single curve. Typically, one curve is located in the thoracic (middle/upper back) region, and the other is a compensatory curve in the lumbar (lower back) region.
The spine in sigmoid scoliosis not only bends sideways but also twists or rotates. Medical professionals measure the severity of these curves using a metric called the Cobb angle, which quantifies the degree of the spinal deviation. A curve is generally considered scoliosis if it measures 10 degrees or greater, with classifications of mild (10-24 degrees), moderate (25-39 degrees), and severe (40+ degrees) based on this measurement.
Causes of Sigmoid Scoliosis
Sigmoid scoliosis can stem from various underlying factors, although in many instances, a clear cause remains unidentified. Idiopathic scoliosis, the most common form, accounts for approximately 80% of all cases and has an unknown origin. This type often emerges during adolescence and may have a genetic component.
Other less common causes include congenital scoliosis, which is present at birth due to abnormal spinal bone formation. Neuromuscular scoliosis arises from conditions that affect the nerves or muscles supporting the spine, such as cerebral palsy or muscular dystrophy. Additionally, degenerative scoliosis can develop in older adults as a result of age-related wear and tear on the spinal discs and joints.
Recognizing the Signs
Identifying sigmoid scoliosis often involves noticing visual and physical asymmetries. Common indicators include uneven shoulders, where one appears higher, or one hip appearing to stick out or be higher. These imbalances can lead to an uneven waistline or a noticeable leaning to one side.
Another visible sign is a more prominent shoulder blade. The head may also not be centered directly over the pelvis. Rib cage asymmetry, often referred to as a “rib hump,” becomes apparent, particularly when a person bends forward. While pain is not always a primary symptom, especially in children, adults with scoliosis may experience discomfort or back pain due to the compressive forces on the spine.
Diagnosing Sigmoid Scoliosis
Medical professionals employ a series of steps to diagnose sigmoid scoliosis and assess its characteristics. The diagnostic process typically begins with a physical examination, where the healthcare provider observes the patient’s posture and spinal alignment. A key part of this examination is the Adam’s forward bend test, where the patient bends forward at the waist. This test allows the doctor to visually check for any spinal curvature, rib prominence, or other asymmetries, as the spine and any rotational components become more visible.
If the physical examination suggests the presence of scoliosis, imaging tests are then utilized to confirm the diagnosis and measure the curve. X-rays are the primary tool, providing detailed images of the spine to visualize the curves and determine their location and severity. In some cases, if there is a concern about underlying conditions or nerve involvement, further imaging such as MRI (Magnetic Resonance Imaging) or CT (Computed Tomography) scans might be recommended.
Treatment Approaches
Treatment strategies for sigmoid scoliosis are tailored to individual factors, including age, curve severity, and progression potential. For mild curves, especially in growing children, observation is a common initial approach. This involves regular monitoring, typically every four to six months, to track changes in spinal curvature.
For moderate curves in growing adolescents, bracing may be recommended to prevent worsening. A brace applies pressure to the spine, guiding its growth straighter. Physical therapy and specific exercises can improve posture, strengthen core muscles, and enhance flexibility, which may alleviate symptoms. In severe, progressing cases, surgery, often spinal fusion, may be considered. Spinal fusion aims to straighten and stabilize the spine by joining vertebrae, preventing further progression and reducing curvature.